title: Preclinical left ventricular diastolic dysfunction in metabolic syndrome.
abstract: Metabolic syndrome (MS) is commonly associated with left ventricular (LV) diastolic dysfunction and LV hypertrophy. We sought to examine whether preclinical LV diastolic dysfunction can occur independent of LV hypertrophy in MS. We recruited 90 consecutive participants with MS and without cardiovascular disease (mean age 46 years, 78% women) and 26 controls (no risk factors for MS; mean age 43 years, 65% women). Participants underwent echocardiography with tissue Doppler imaging. In age- and gender-adjusted analyses, MS was associated with higher left atrial (LA) diameter, higher LV mass, lower E/A ratio, and lower mean e' (p <0.001 for all). These associations remained significant after further adjusting for blood pressure, antihypertensive medication use, and body mass index. After adjusting for LV mass, MS remained independently associated with higher LA diameter, lower E/A ratio, and lower mean e' (p ≤0.01 for all). Specifically, subjects with MS had a 1.8 cm/s lower mean e' compared with controls (p = 0.01). Notably, differences in mean e' between those with and without MS were more pronounced at younger ages (p for interaction = 0.003). In conclusion, MS was associated with preclinical LV diastolic dysfunction independent of LV mass, as reflected by higher LA diameter, lower E/A ratio, and lower mean e'. This suggests that MS can lead to the development of diastolic dysfunction through mechanisms independent of hypertrophy. Differences in diastolic function were more pronounced at younger ages, highlighting the potential importance of early risk factor modification and preventive strategies in MS.
authors.affiliation: Cardiovascular Medicine Section, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Nir
authors.initials: N
authors.lastname: Ayalon
authors.affiliation: Cardiovascular Medicine Section, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Deepa M
authors.initials: DM
authors.lastname: Gopal
authors.affiliation: Cardiovascular Medicine Section, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Deirdre M
authors.initials: DM
authors.lastname: Mooney
authors.affiliation: Endocrinology, Diabetes and Nutrition Section, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Juliana S
authors.initials: JS
authors.lastname: Simonetti
authors.affiliation: Department of Medicine, Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Jason R
authors.initials: JR
authors.lastname: Grossman
authors.affiliation: Department of Medicine, Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Aeshita
authors.initials: A
authors.lastname: Dwivedi
authors.affiliation: Cardiovascular Medicine Section, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Courtney
authors.initials: C
authors.lastname: Donohue
authors.affiliation: Cardiovascular Medicine Section, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Alejandro J
authors.initials: AJ
authors.lastname: Perez
authors.affiliation: Cardiovascular Medicine Section, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Jill
authors.initials: J
authors.lastname: Downing
authors.affiliation: Cardiovascular Medicine Section, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Noyan
authors.initials: N
authors.lastname: Gokce
authors.affiliation: Cardiovascular Medicine Section, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Miller
authors.affiliation: Cardiovascular Medicine Section, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Chang-Seng
authors.initials: CS
authors.lastname: Liang
authors.affiliation: Endocrinology, Diabetes and Nutrition Section, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Caroline M
authors.initials: CM
authors.lastname: Apovian
authors.affiliation: Cardiovascular Medicine Section, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Wilson S
authors.initials: WS
authors.lastname: Colucci
authors.affiliation: Cardiovascular Medicine Section, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts. Electronic address: Jennifer.Ho@bmc.org.
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Ho
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003971:Diastole; D018619:Echocardiography, Doppler, Pulsed; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D015994:Incidence; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D024821:Metabolic Syndrome / Q000150:complications* / Q000503:physiopathology; D008875:Middle Aged; D015995:Prevalence; D018487:Ventricular Dysfunction, Left / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology
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