Assessment Of Left Ventricular Structures And Functions In Patients With Metabolic Syndrome By Transthoracic Echo Cardiography And Tissue Doppler Study

Abstract

Background: MetS is a cluster of cardiovascular risk factors related with rose mortality and morbidity. Its impact on heart function and structure, particularly left ventricular (LV) performance, remains incompletely defined.

Objective: To assess LV functional and structural changes in cases with MetS using transthoracic echocardiography and tissue Doppler imaging (TDI).

Methods: This research involved 60 cases. All of them underwent echocardiographic assessment at Echocardiography Unit, Al-Azhar University Hospital (Assiut), Those cases have been categorized into three groups: Control Group(A): twenty persons with absent (0) any criteria of metabolic syndrome. Study Group(B): 20 persons with pre-metabolic syndrome (1-2 criteria). Study Group(C): 20 persons with metabolic syndrome (≥3 criteria).

Results: left ventricular systolic function by ejection fraction has been preserved across all groups. However, MPI by PWD and TDI was significantly greater in MetS patients (0.48±0.08 and 0.55±0.12, correspondingly) in comparison with controls (0.41±0.02 and 0.47±0.02; p<0.001). S’ velocity was reduced in MetS (9.3±2.08 cm/s) compared with controls (12.4±1.46 cm/s; p<0.0001). Diastolic function parameters were impaired in MetS, with lower E/A ratio (0.83±0.20 vs. 1.35±0.13, p<0.0001), higher E/E′ (13.29±3.92 vs. 5.32±1.09, p<0.0001), and prolonged IVRT (100.55±24.91 ms vs. 74.65±4.91 ms, p<0.0001). LVMI/Ht^2.7 and RWT were significantly elevated in MetS than controls, indicating hypertrophy and concentric remodeling.

Conclusion: MetS is related to subclinical LV diastolic & systolic dysfunction, increased LV mass, and concentric remodeling despite preserved ejection fraction. Echocardiography with TDI provides sensitive detection of early myocardial impairment in these cases.