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Min CY, Gao Y, Jiang YN, Guo YK, Shi K, Yang ZG, Li Y. The additive effect of metabolic syndrome on left ventricular impairment in patients with obstructive coronary artery disease assessed by 3.0 T cardiac magnetic resonance feature tracking. Cardiovasc Diabetol 2024; 23:133. [PMID: 38654269 DOI: 10.1186/s12933-024-02225-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 04/07/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) can increase the risk of morbidity and mortality of cardiovascular disease and obstructive coronary artery disease (OCAD), which usually have a poor prognosis. This study aimed to explore the impact of MetS on left ventricular (LV) deformation and function in OCAD patients and investigate the independent factors of impaired LV function and deformation. MATERIALS AND METHODS A total of 121 patients with OCAD and 52 sex- and age-matched controls who underwent cardiac magnetic resonance scanning were enrolled in the study. All OCAD patients were divided into two groups: OCAD with MetS [OCAD(MetS+), n = 83] and OCAD without MetS [OCAD(MetS-), n = 38]. LV functional and global strain parameters were measured and compared among the three groups. Multivariable linear regression analyses were constructed to investigate the independent factors of LV impairment in OCAD patients. Logistic regression analysis and receiver operating characteristic (ROC) curve analysis were performed to test the prediction efficiency of MetS for LV impairment. RESULTS From controls to the OCAD(MetS-) group to the OCAD(MetS+) group, LV mass (LVM) increased, and LV global function index (LVGFI) and LV global longitudinal peak strain (GLPS) decreased (all p < 0.05). Compared with the OCAD(MetS-) group, the LV GLPS declined significantly (p = 0.027), the LVM increased (p = 0.006), and the LVGFI decreased (p = 0.043) in the OCAD(MetS+) group. After adjustment for covariates in OCAD patients, MetS was an independent factor of decreased LV GLPS (β = - 0.211, p = 0.002) and increased LVM (β = 0.221, p = 0.003). The logistic multivariable regression analysis and ROC analysis showed that combined MetS improved the efficiency of predicting LV GLPS reduction (AUC = 0.88) and LVM (AUC = 0.89) increase. CONCLUSIONS MetS aggravated the damage of LV deformation and function in OCAD patients and was independently associated with LV deformation and impaired LV strain. Additionally, MetS increased the prediction efficiency of increased LVM and decreased LV GLPS. Early detection and intervention of MetS in patients with OCAD is of great significance.
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Affiliation(s)
- Chen-Yan Min
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Yue Gao
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Yi-Ning Jiang
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Ying-Kun Guo
- Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Department of Radiology, West China Second University Hospital, Sichuan University, 20# Section 3, Renmin South Road, Chengdu, 610041, Sichuan, China
| | - Ke Shi
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Zhi-Gang Yang
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China.
| | - Yuan Li
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China.
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Zhou D, Ye Z, Nie Z, Chen C, Luo S, Yan M, Wang J, Feng Y. Positive additive interaction effects of age, sex, obesity, and metabolic syndrome on left ventricular dysfunction. J Diabetes 2024; 16:e13478. [PMID: 37743094 PMCID: PMC10809287 DOI: 10.1111/1753-0407.13478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 08/18/2023] [Accepted: 09/03/2023] [Indexed: 09/26/2023] Open
Abstract
OBJECTIVE This study aims to explore the association between metabolic syndrome (MetS) and left ventricular diastolic dysfunction (LVDD) and systolic dysfunction (LVSD), defined by impaired global longitudinal strain (GLS), and assess additive and multiplicative interactions among age, sex, obesity, and MetS regarding LVDD and LVSD. METHODS We prospectively recruited 5503 participants from the China PEACE (Patient-Centered Evaluative Assessment of Cardiac Events) Million Persons Project with complete echocardiography exam. Multivariable logistic models were used to calculate adjusted odds ratios to evaluate both additive and multiplicative interactions. RESULTS The mean age was 56.59 years; 59.4% were women, 46.7% had MetS, 26.6% had left ventricular hypertrophy, 46.3% had LVDD, and 12.50% had impaired GLS. Compared to the non-MetS, the odds ratio (OR) of LVDD and impaired GLS in MetS were 1.40 (1.20-1.64) and 1.26 (1.03-1.54), respectively. For LVDD, relative excess risk due to additive interaction (RERI) for women and MetS, elderly and MetS, obesity and MetS were 0.76 (0.02-1.50), 35.65 (17.51-53.79), and 2.14 (0.66-3.62), respectively, thus suggesting additive interactions. For impaired GLS, RERI for obesity and MetS was 3.37 (0.50-6.24), thus suggesting additive interactions. CONCLUSIONS The MetS is independently associated with LVDD and impaired GLS. From the public health implications, prevention of MetS in women, elderly, and obese individuals might result in a greater reduction of LVDD and LVSD risk in cardiovascular high-risk population.
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Affiliation(s)
- Dan Zhou
- Department of CardiologyGuangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical UniversityGuangzhouChina
- Department of Internal MedicineShenzhen People's Hospital (The Second Clinical Medical College, Jinan University; the First Affiliated Hospital, Southern University of Science and Technology)ShenzhenChina
| | - Zhongwen Ye
- Zhuhai Center for Disease Control and PreventionZhuhaiChina
| | - Zhiqiang Nie
- Department of CardiologyGuangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical UniversityGuangzhouChina
- Global Health Research Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical SciencesSouthern Medical UniversityGuangzhouChina
| | - Chaolei Chen
- Department of CardiologyGuangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical UniversityGuangzhouChina
| | - Songyuan Luo
- Department of CardiologyGuangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical UniversityGuangzhouChina
| | - Mengqi Yan
- Department of CardiologyGuangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical UniversityGuangzhouChina
| | - Jiabin Wang
- Department of CardiologyGuangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical UniversityGuangzhouChina
- Global Health Research Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical SciencesSouthern Medical UniversityGuangzhouChina
| | - Yingqing Feng
- Department of CardiologyGuangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical UniversityGuangzhouChina
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Chen H, Liu L, Li M, Zhu D, Tian G. Epicardial Adipose Tissue-Derived Leptin Promotes Myocardial Injury in Metabolic Syndrome Rats Through PKC/NADPH Oxidase/ROS Pathway. J Am Heart Assoc 2023; 12:e029415. [PMID: 37489731 PMCID: PMC10492984 DOI: 10.1161/jaha.123.029415] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 06/19/2023] [Indexed: 07/26/2023]
Abstract
Background The epicardial adipose tissue (EAT) of metabolic syndrome (MetS) is abnormally accumulated with dysfunctional secretion of adipokines, closely relating to cardiac dysfunction. The current study was designed to identify the effects of EAT-derived leptin on the myocardium of MetS rats and explore the potential molecular mechanisms. Methods and Results A MetS rat model was established in 8-week-old Wistar rats by a 12-week high-fat diet. MetS rats exhibited increased leptin secretion from EAT, cardiac hypertrophy, and diastolic dysfunction with preserved systolic function. The myocardium of MetS rats had abnormal structure, increased oxidative stress injury, and higher inflammatory factor levels, especially the subepicardial myocardium, which was correlated with the EAT-derived leptin level but not the serum leptin. The EAT was separated from each group of rats to prepare EAT-conditioned medium. H9C2 rat cardiomyoblasts were treated with EAT-conditioned medium or leptin, plus various inhibitors. EAT-derived leptin from MetS rats promoted mitochondrial oxidative stress and dysfunction, induced mitochondrial pathway apoptosis, and inhibited cell viability in H9C2 cardiomyoblasts via the protein kinase C/reduced nicotinamide adenine dinucleotide phosphate oxidase/reactive oxygen species (PKC/NADPH oxidase/ROS) pathway. EAT-derived leptin from MetS rats stimulated inflammation in H9C2 cardiomyocytes by promoting activator protein 1 nuclear translocation via the PKC/NADPH oxidase/ROS pathway. Leptin promoted the interaction between p-p47phox and gp91phox in H9C2 cardiomyocytes via protein kinase C, activating nicotinamide adenine dinucleotide phosphate oxidase, increasing reactive oxygen species generation, and inhibiting cell viability. Conclusions EAT-derived leptin induces MetS-related myocardial injury through the following 2 cooperative ways via PKC/NADPH oxidase/ROS pathway: (1) inducing mitochondrial pathway apoptosis by promoting mitochondrial oxidative stress and dysfunction; and (2) stimulating inflammation by promoting activator protein 1 nuclear translocation.
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Affiliation(s)
- Hui Chen
- Heart Center of Henan Provincial People’s Hospital, Central China Fuwai HospitalCentral China Fuwai Hospital of Zhengzhou UniversityZhengzhouHenanChina
| | - Lei Liu
- Department of CardiologyThe First Affiliated Hospital of Xi’an Jiao Tong UniversityXi’anShaanxiChina
| | - Min Li
- Department of CardiologyThe First Affiliated Hospital of Xi’an Jiao Tong UniversityXi’anShaanxiChina
| | - Danjun Zhu
- Department of CardiologyThe First Affiliated Hospital of Xi’an Jiao Tong UniversityXi’anShaanxiChina
| | - Gang Tian
- Department of CardiologyThe First Affiliated Hospital of Xi’an Jiao Tong UniversityXi’anShaanxiChina
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Parve SD, Sineglazova AV. Cardiac Structure and Function in Young Adults With Various Cardiometabolic Profiles. Cureus 2023; 15:e40524. [PMID: 37333045 PMCID: PMC10275507 DOI: 10.7759/cureus.40524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 06/16/2023] [Indexed: 06/20/2023] Open
Abstract
Background Cardiovascular diseases are a leading cause of mortality worldwide. Cardiometabolic abnormalities result in alterations in the myocardial structure and function. Limited data are available on these changes in young adults with various cardiometabolic risk profiles. The goal was to study the relationship between cardiometabolic risk and echocardiographic changes in young patients of both sexes in a Russian population, using a risk-based cardiometabolic disease staging (CMDS) system. Methods A total of 191 patients were included. The patients were classified into five groups based on the CMDS system. We gathered patient history and performed a physical exam, biochemical blood analysis, and echocardiography. Statistical analyses were performed using IBM SPSS Statistics for Windows, Version 23 (Released 2015; IBM Corp., Armonk, New York, United States). Results The median age of the participants was 35 (30.0-39.0) years. Elevated systolic and diastolic blood pressure and hypertriglyceridemia were more frequent (p < 0.05) in males than in females. An increase in the end-diastolic volume (EDV) and end-systolic volume (ESV) and a decrease in the ejection fraction were noted from CMDS 0 to 3. The EDV and ESV were associated with most cardiometabolic risk factors and strongly correlated with the visceral fat level, waist circumference, and body mass index. We identified a new subgroup as CMDS 3-overly high in patients with CMDS 3 and an excess level of visceral fat. Conclusion When designing strategies for cardiovascular disease prevention in young adults apart from CMDS parameters, bioimpedance analysis should be considered to assess the level of visceral fat, especially in individuals with CMDS 3 because they are at a higher risk of cardiac chamber enlargements. These results can be used to identify new dominants or phenotypes of heart failure with preserved ejection fraction.
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Affiliation(s)
- Swapnil D Parve
- Primary Care and General Practice, Kazan State Medical University, Kazan, RUS
- Research and Development, Datta Meghe Institute of Higher Education & Research (Deemed to be University), Wardha, IND
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Richard SL, Renn BN, Kim J, Tran DMT, Feng D. Mental health is related to metabolic syndrome: The Hispanic community health study/ study of Latinos. Psychoneuroendocrinology 2023; 152:106085. [PMID: 36989563 PMCID: PMC10249587 DOI: 10.1016/j.psyneuen.2023.106085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 01/28/2023] [Accepted: 03/13/2023] [Indexed: 03/31/2023]
Abstract
OBJECTIVE Metabolic syndrome (MetS) is associated with common mental health conditions. Using cross-sectional data from the observational Hispanic Community Health Study / Study of Latinos (HCHS/SOL), this study examined the relationship between MetS and depression and anxiety in addition to testing moderating effects of gender and Hispanic heritage subgroups. METHODS Participants included 13,496 Hispanic Americans aged 18-74 (59% women, mean age 46.59 ± 13.65) from seven heritage subgroups. Depression was measured using the Center for Epidemiologic Studies Depression 10-item scale, and anxiety was assessed using the State-Trait Anxiety Inventory 10-item scale. A 3-level categorical variable was developed to assess the combined influence of depression and anxiety. The dependent variable is dichotomous, delineating the presence or absence of MetS as defined by the National Cholesterol Education Program Third Adult Treatment Panel. Logistic regression and Hayes' PROCESS macro assessed these relationships and the moderating effects of gender-heritage subgroups. RESULTS Results suggest depression (p < .001) and anxiety (p < .001) were associated with an increased likelihood of MetS. Puerto Ricans had the highest, and South Americans had the lowest, levels of depression and anxiety. Gender moderated the relationship between mental health and MetS, with women having a significant increase in the probability of MetS with depression (p < .001), anxiety (p < .001), or both (p < .001). CONCLUSION Elevated symptoms of depression and anxiety are associated with the presence of MetS in US Hispanic subgroups. Gender-heritage differences are present among the study variables. Strategies to manage psychological well-being must be employed to optimize cardiometabolic health in US Hispanics.
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Affiliation(s)
| | | | | | | | - Du Feng
- 4505 S Maryland Pky, Las Vegas, NV 89154, USA
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Pirzada A, Cai J, Heiss G, Sotres-Alvarez D, Gallo LC, Youngblood ME, Avilés-Santa ML, González HM, Isasi CR, Kaplan R, Kunz J, Lash JP, Lee DJ, Llabre MM, Penedo FJ, Rodriguez CJ, Schneiderman N, Sofer T, Talavera GA, Thyagarajan B, Wassertheil-Smoller S, Daviglus ML. Evolving Science on Cardiovascular Disease Among Hispanic/Latino Adults: JACC International. J Am Coll Cardiol 2023; 81:1505-1520. [PMID: 37045521 DOI: 10.1016/j.jacc.2023.02.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 01/03/2023] [Accepted: 02/07/2023] [Indexed: 04/14/2023]
Abstract
The landmark, multicenter HCHS/SOL (Hispanic Community Health Study/Study of Latinos) is the largest, most comprehensive, longitudinal community-based cohort study to date of diverse Hispanic/Latino persons in the United States. The HCHS/SOL aimed to address the dearth of comprehensive data on risk factors for cardiovascular disease (CVD) and other chronic diseases in this population and has expanded considerably in scope since its inception. This paper describes the aims/objectives and data collection of the HCHS/SOL and its ancillary studies to date and highlights the critical and sizable contributions made by the study to understanding the prevalence of and changes in CVD risk/protective factors and the burden of CVD and related chronic conditions among adults of diverse Hispanic/Latino backgrounds. The continued follow-up of this cohort will allow in-depth investigations on cardiovascular and pulmonary outcomes in this population, and data from the ongoing ancillary studies will facilitate generation of new hypotheses and study questions.
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Affiliation(s)
- Amber Pirzada
- Institute for Minority Health Research, University of Illinois Chicago, Chicago, Illinois, USA.
| | - Jianwen Cai
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Gerardo Heiss
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Daniela Sotres-Alvarez
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Marston E Youngblood
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - M Larissa Avilés-Santa
- Division of Clinical and Health Services Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland, USA
| | - Hector M González
- Department of Neurosciences, University of California San Diego, San Diego, California, USA
| | - Carmen R Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Robert Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - John Kunz
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - James P Lash
- Department of Medicine, University of Illinois Chicago, Chicago, Illinois, USA
| | - David J Lee
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Maria M Llabre
- Department of Psychology, University of Miami, Miami, Florida, USA
| | - Frank J Penedo
- Department of Psychology, University of Miami, Miami, Florida, USA
| | - Carlos J Rodriguez
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
| | | | - Tamar Sofer
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Gregory A Talavera
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Bharat Thyagarajan
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Sylvia Wassertheil-Smoller
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois Chicago, Chicago, Illinois, USA
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Zhao L, Sun L, Yang K, Li Z, Wang Y, Wang T, Wang M, Zeng Y, Zhou X, Yang W. Effects of Metabolic Syndrome on Cardiovascular Outcomes of Psoriatic Patients with Coronary Artery Disease: A Single Center Retrospective Cohort Study. Diabetes Metab Syndr Obes 2023; 16:1003-1012. [PMID: 37063255 PMCID: PMC10103782 DOI: 10.2147/dmso.s402618] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 03/30/2023] [Indexed: 04/18/2023] Open
Abstract
BACKGROUND Psoriasis is associated with an increased prevalence of cardiovascular risk factors, including metabolic syndrome (MetS). To date, it is unclear whether MetS causes differences in cardiovascular outcomes in psoriatic patients with coronary artery disease. METHODS We conducted a retrospective cohort study to determine the effects of MetS in psoriatic patients with coronary artery disease. Comparisons were made between patients with and without MetS. Cox regression analysis and Kaplan-Meier survival analysis were used to evaluate the association between variables. RESULTS Of the 307 psoriatic patients with coronary artery disease, 94 met criteria (30.6%) for MetS. Individuals with MetS were more likely to be female (p <0.001). Levels of platelet counts and high-sensitivity C-reactive protein were higher in the MetS group (p = 0.038 and 0.005, respectively). After a mean follow-up of 35.32 months, major adverse cardiovascular events (MACEs) and non-fatal myocardial infarction were more likely in the MetS than the non-MetS group (33.3% vs 20.6%, p = 0.02; 26.4% vs 15.7%, p = 0.032, respectively). Kaplan-Meier estimates showed the same trend. Cox regression analysis showed that MetS (hazard ratio 1.738; 95% confidence interval 1.045-2.891; p = 0.033) and left ventricular ejection fraction (hazard ratio 0.968; 95% confidence interval 0.945-0.991; p = 0.006) were associated with an increased risk of MACEs. CONCLUSION In psoriatic patients with coronary artery disease, MetS independently predicted MACEs. In addition, left ventricular ejection fraction was negatively associated with an increased risk of MACEs. To reduce the cardiovascular disease risk, it is necessary to increase awareness of MetS in psoriatic patients with coronary artery disease.
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Affiliation(s)
- Lin Zhao
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Lin Sun
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Kunqi Yang
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Zuozhi Li
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Yan Wang
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Tianjie Wang
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Man Wang
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Yan Zeng
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
- Correspondence: Yan Zeng; Xianliang Zhou, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167, Beilishi Road, Beijing, 100037, People’s Republic of China, Email ;
| | - Xianliang Zhou
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Weixian Yang
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
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Alterations in diastolic function and cardiac geometry in children: a longitudinal study across the spectrum of dialysis and transplant. Pediatr Nephrol 2022; 38:1887-1896. [PMID: 36357638 DOI: 10.1007/s00467-022-05771-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/26/2022] [Accepted: 09/21/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND Children with kidney failure have increased risk for cardiovascular morbidities before and after transplantation. Ejection fraction is often preserved, masking cardiac dysfunction until severe. Data on longitudinal changes in diastolic function and cardiac geometry are limited. METHODS A prospective study was conducted to investigate longitudinal changes in diastolic function and structure pre- and post-kidney transplant compared with healthy peers. Transplant recipients (n = 41) had echocardiograms pre-transplant, 1, 18, 30, and 42 months post-transplant. The controls (n = 26) underwent one echocardiogram. Diastolic function and cardiac geometry were assessed by E/e' lateral, E/A, interventricular septal end diastole diameter, left ventricular internal end diastole diameter, left ventricular posterior wall end diastole diameter, and left atrial dimension. RESULTS E/e' of patients remained worse than controls until 30 months post-transplant, and E/A was impaired at all time points compared to the controls. Left ventricular geometry was abnormal in 46% pre-transplant and remained altered in 44.7%, 32.3%, 30.7%, and 27.2% at 1, 18, 30, and 42 months post-transplant. Determinants of diastolic dysfunction included hemodialysis, uncontrolled hypertension, steroid exposure, and metabolic syndrome; abnormal geometry was associated with glomerular diagnosis, dialysis duration, obesity, steroids, and metabolic syndrome. Abnormal diastolic function and structure were associated with left ventricular hypertrophy. CONCLUSION Diastolic dysfunction and geometry partially improve after transplant but remain abnormal in a subset of patients compared to healthy peers. Traditional indicators of systolic function are preserved. Modifiable risk factors include dialysis modality and duration, uncontrolled hypertension, corticosteroids, obesity, and metabolic syndrome. Attention to diastolic changes provides opportunity for early intervention. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Zhu Y, Li G, Laukkanen JA, Song X, Zhang J, Wei L, Chen X, Li Y, Liu C. Higher neutrophil to lymphocyte ratio is associated with renal dysfunction and cardiac adverse remodeling in elderly with metabolic syndrome. Front Cardiovasc Med 2022; 9:921204. [PMID: 36158844 PMCID: PMC9492939 DOI: 10.3389/fcvm.2022.921204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 08/15/2022] [Indexed: 11/17/2022] Open
Abstract
Background Previous studies have shown that metabolic syndrome (MetS) is associated with increased systemic inflammation and cardiac mortality in elderly subjects. However, information on the association of inflammation markers with cardiac adverse remodeling is limited in the elderly with MetS. Therefore, we investigated whether the inflammatory marker neutrophil/lymphocyte ratio (NLR) is associated with the cardiac adverse remodeling in Chinese elderly with MetS. Methods A total of 1,087 hospitalized Chinese elderly (aged ≥ 65 years) with MetS were collected retrospectively. The cross-sectional data of echocardiography and clinical parameters were compared among quartile NLR groups. Results In the elderly with MetS, higher quartile NLR (≥3.83) was found to be associated with male gender, older age, lower estimated glomerular filtration rate (eGFR), and cardiac left ventricular (LV) dilatation (all p <0.05). Conclusion Higher NLR is associated with male gender, older age, renal dysfunction, and cardiac adverse remodeling in Chinese elderly with MetS.
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Affiliation(s)
- Yuqi Zhu
- Division of Cardiology, Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Gang Li
- Division of Cardiology, Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- *Correspondence: Gang Li
| | - Jari A. Laukkanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Department of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Medicine, Central Finland Health Care District, Jyväskylä, Finland
| | - Xing Song
- Division of Cardiology, Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jing Zhang
- Division of Cardiology, Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Linping Wei
- Division of Cardiology, Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xinrui Chen
- Division of Cardiology, Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yufeng Li
- Division of Cardiology, Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Cheng Liu
- Division of Cardiology, Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Tudoran C, Tudoran M, Cut TG, Lazureanu VE, Bende F, Fofiu R, Enache A, Pescariu SA, Novacescu D. The Impact of Metabolic Syndrome and Obesity on the Evolution of Diastolic Dysfunction in Apparently Healthy Patients Suffering from Post-COVID-19 Syndrome. Biomedicines 2022; 10:biomedicines10071519. [PMID: 35884823 PMCID: PMC9312435 DOI: 10.3390/biomedicines10071519] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/21/2022] [Accepted: 06/24/2022] [Indexed: 12/13/2022] Open
Abstract
(1) Background: Coronavirus disease 2019 (COVID-19) has a worse prognosis in individuals with obesity and metabolic syndrome (MS), who often develop cardiovascular complications that last throughout recovery. (2) Methods: This study aimed to analyze the evolution of diastolic dysfunction (DD), assessed by transthoracic echocardiography (TTE), in 203 individuals with and without obesity and/or MS diagnosed with post-COVID-19 syndrome. (3) Results: DD was frequently diagnosed in patients with MS and obesity, but also in those without obesity (62.71% and 56.6%, respectively), in comparison to 21.97% of subjects without MS (p ˂ 0.001). Almost half of the patients with obesity and MS had more severe DD (types 2 and 3). As for evolution, the prevalence and severity of DD, particularly types 1 and 2, decreased gradually, in parallel with the improvement of symptoms, progress being more evident in subjects without MS. DD of type 3 did not show a significant reduction (p = 0.47), suggesting irreversible myocardial damages. Multivariate regression analysis indicated that the number of MS factors, the severity of initial pulmonary injury, and protein C levels could explain DD evolution. (4) Conclusions: DD was commonly diagnosed in individuals with post-COVID-19 syndrome, particularly in those with MS and obesity. After 6 months, DD evolution, excepting that of type 3, showed a significant improvement, mostly in patients without MS.
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Affiliation(s)
- Cristina Tudoran
- Department VII, Internal Medicine II, University of Medicine and Pharmacy “Victor Babes” Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania; (C.T.); (F.B.)
- Center of Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, University of Medicine and Pharmacy “Victor Babeș” Timișoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania
- County Emergency Hospital, L. Rebreanu Str., Nr. 156, 300723 Timisoara, Romania; (R.F.); (D.N.)
- Academy of Romanian Scientists, Splaiul Independentei Nr. 54, 50085 Bucuresti, Romania;
| | - Mariana Tudoran
- Department VII, Internal Medicine II, University of Medicine and Pharmacy “Victor Babes” Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania; (C.T.); (F.B.)
- Center of Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, University of Medicine and Pharmacy “Victor Babeș” Timișoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania
- County Emergency Hospital, L. Rebreanu Str., Nr. 156, 300723 Timisoara, Romania; (R.F.); (D.N.)
- Correspondence: (M.T.); (T.G.C.); Tel.: +40-722310302 (M.T.)
| | - Talida Georgiana Cut
- Academy of Romanian Scientists, Splaiul Independentei Nr. 54, 50085 Bucuresti, Romania;
- Department XIII, Discipline of Infectious Diseases, University of Medicine and Pharmacy “Victor Babes” Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania;
- Center for Ethics in Human Genetic Identification, University of Medicine and Pharmacy “Victor Babes” Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania;
- Doctoral School, University of Medicine and Pharmacy “Victor Babes”, 300041 Timisoara, Romania
- Correspondence: (M.T.); (T.G.C.); Tel.: +40-722310302 (M.T.)
| | - Voichita Elena Lazureanu
- Department XIII, Discipline of Infectious Diseases, University of Medicine and Pharmacy “Victor Babes” Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania;
| | - Felix Bende
- Department VII, Internal Medicine II, University of Medicine and Pharmacy “Victor Babes” Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania; (C.T.); (F.B.)
- County Emergency Hospital, L. Rebreanu Str., Nr. 156, 300723 Timisoara, Romania; (R.F.); (D.N.)
- Center of Advanced Research in Gastroenterology and Hepatology, Faculty of Medicine, University of Medicine and Pharmacy “Victor Babes” Timisoara, 300041 Timisoara, Romania
| | - Renata Fofiu
- County Emergency Hospital, L. Rebreanu Str., Nr. 156, 300723 Timisoara, Romania; (R.F.); (D.N.)
- Doctoral School, University of Medicine and Pharmacy “Victor Babes”, 300041 Timisoara, Romania
- Center of Advanced Research in Gastroenterology and Hepatology, Faculty of Medicine, University of Medicine and Pharmacy “Victor Babes” Timisoara, 300041 Timisoara, Romania
| | - Alexandra Enache
- Center for Ethics in Human Genetic Identification, University of Medicine and Pharmacy “Victor Babes” Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania;
- Department VIII, Discipline of Forensic Medicine, University of Medicine and Pharmacy “Victor Babes” Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania
| | - Silvius Alexandru Pescariu
- Academy of Romanian Scientists, Splaiul Independentei Nr. 54, 50085 Bucuresti, Romania;
- Department VI, Cardiology, University of Medicine and Pharmacy “Victor Babes” Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania
| | - Dorin Novacescu
- County Emergency Hospital, L. Rebreanu Str., Nr. 156, 300723 Timisoara, Romania; (R.F.); (D.N.)
- Academy of Romanian Scientists, Splaiul Independentei Nr. 54, 50085 Bucuresti, Romania;
- Doctoral School, University of Medicine and Pharmacy “Victor Babes”, 300041 Timisoara, Romania
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Garg PK, Biggs ML, Kizer JR, Shah SJ, Djousse L, Mukamal KJ. Associations of body size and composition with subclinical cardiac dysfunction in older individuals: the cardiovascular health study. Int J Obes (Lond) 2021; 45:2539-2545. [PMID: 34349227 DOI: 10.1038/s41366-021-00926-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 07/13/2021] [Accepted: 07/23/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Focused studies in younger to middle-aged populations have demonstrated a relationship between obesity and adverse cardiac mechanics. We examined whether measures of overall and central adiposity are associated with cardiac mechanics, assessed by speckle-tracking echocardiography, in an older population without prevalent coronary heart disease or heart failure. METHODS Body composition was measured by anthropometry, bioelectrical impedance, and dual-energy x-ray absorptiometry among participants in the Cardiovascular Health Study, a population-based cohort of adults aged 65 years or older. Systolic and diastolic cardiac mechanics were measured with speckle-tracking analysis of echocardiograms. Multi-variable adjusted linear regression models were used to investigate associations of body composition measures and cardiac mechanics. RESULTS Mean age for the 3525 included participants was 72.6 years, 39% were male, and 10% were black. Mean body-mass index (BMI) was 26.3 ± 4.4 kg/m2, waist circumference (WC) was 93.2 ± 12.9 cm, and waist-to-hip ratio was 0.92 ± 0.09. In fully adjusted analyses, all adiposity measures were associated with worse LV longitudinal strain, LV early diastolic strain rate, and left atrial reservoir strain; however, associations were strongest for WC and BMI (p < 0.001). When both BMI and WC were included in the same model, only WC remained associated with each cardiac strain measure. CONCLUSION In this cross-sectional study of older adults, central obesity was most robustly associated with impaired left ventricular systolic and diastolic strain as well as left atrial strain. The adverse effects of central obesity appear to extend even into older age.
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Affiliation(s)
- Parveen K Garg
- Division of Cardiology, University of Southern California Keck School of Medicine, Los Angeles, CA, USA.
| | - Mary L Biggs
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Jorge R Kizer
- Cardiology Section, San Francisco Veterans Affairs Health Care System, and Department of Medicine, University of California San Francisco, San Francisco, CA, USA.,Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Sanjiv J Shah
- Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Luc Djousse
- Division of Aging, Department of Medicine Brigham and Women's Hospital, Boston, MA, USA
| | - Kenneth J Mukamal
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
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d'Entremont MA, Fortin G, Huynh T, Croteau É, Farand P, Lemaire-Paquette S, Brochu MC, Do DH, Lepage S, Mampuya WM, Couture ÉL, Nguyen M, Essadiqi B. The feasibility, reliability, and incremental value of two-dimensional speckle-tracking for the detection of significant coronary stenosis after treadmill stress echocardiography. Cardiovasc Ultrasound 2021; 19:27. [PMID: 34301240 PMCID: PMC8305986 DOI: 10.1186/s12947-021-00259-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 07/13/2021] [Indexed: 12/03/2022] Open
Abstract
Background Two-dimensional speckle-tracking echocardiography (STE) may help detect coronary artery disease (CAD) when combined with dobutamine stress echocardiography. However, few studies have explored STE with exercise stress echocardiography (ESE). We aimed to evaluate the feasibility, reliability, and incremental value of STE combined with treadmill ESE compared to treadmill ESE alone to detect CAD. Methods We conducted a case–control study of all consecutive patients with abnormal ESE in 2018–2020 who subsequently underwent coronary angiography within a six-month interval. We 1:1 propensity score-matched these patients to those with a normal ESE. Two blinded operators generated a 17-segment bull's-eye map of longitudinal strain (LS). We utilized the mean differences between stress and baseline LS values in segments 13–17, segment 17, and segments 15–16 to create receiver operator curves for the overall examination, the left anterior descending artery (LAD), and the non-LAD territories, respectively. Results We excluded 61 STEs from 201 (30.3%) eligible ESEs; 47 (23.4%) because of suboptimal image quality and 14 (7.0%) because of excessive heart rate variability precluding the calculation of a bull's-eye map. After matching, a total of 102 patients were included (51 patients in each group). In the group with abnormal ESE patients (mean age 66.4 years, 39.2% female), 64.7% had significant CAD (> 70% stenosis) at coronary angiogram. In the group with normal ESE patients (mean age 65.1 years, 35.3% female), 3.9% were diagnosed with a new significant coronary stenosis within one year. The intra-class correlation for global LS was 0.87 at rest and 0.92 at stress, and 0.84 at rest, and 0.89 at stress for the apical segments. The diagnostic accuracy of combining ESE and STE was superior to visual assessment alone for the overall examination (area under the curve (AUC) = 0.89 vs. 0.84, p = 0.025), the non-LAD territory (AUC = 0.83 vs. 0.70, p = 0.006), but not the LAD territory (AUC = 0.79 vs. 0.73, p = 0.11). Conclusions Two-dimensional speckle-tracking combined with treadmill ESE is relatively feasible, reliable, and may provide incremental diagnostic value for the detection and localization of significant CAD. Supplementary Information The online version contains supplementary material available at 10.1186/s12947-021-00259-w.
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Affiliation(s)
- Marc-André d'Entremont
- Division of Cardiology, Department of Medicine, Sherbrooke University Hospital Center (CHUS) , 3001, 12e Avenue Nord, Sherbrooke, QC, J1H 5N4, Canada. .,Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Gabriel Fortin
- Division of Cardiology, Department of Medicine, Sherbrooke University Hospital Center (CHUS) , 3001, 12e Avenue Nord, Sherbrooke, QC, J1H 5N4, Canada
| | - Thao Huynh
- McGill Health University Center, Montreal, QC, Canada
| | - Étienne Croteau
- Sherbrooke University Hospital Research Center (CRCHUS), Sherbrooke, QC, Canada
| | - Paul Farand
- Division of Cardiology, Department of Medicine, Sherbrooke University Hospital Center (CHUS) , 3001, 12e Avenue Nord, Sherbrooke, QC, J1H 5N4, Canada
| | | | - Marie-Claude Brochu
- Division of Cardiology, Department of Medicine, Sherbrooke University Hospital Center (CHUS) , 3001, 12e Avenue Nord, Sherbrooke, QC, J1H 5N4, Canada
| | - Doan Hoa Do
- Division of Cardiology, Department of Medicine, Sherbrooke University Hospital Center (CHUS) , 3001, 12e Avenue Nord, Sherbrooke, QC, J1H 5N4, Canada
| | - Serge Lepage
- Division of Cardiology, Department of Medicine, Sherbrooke University Hospital Center (CHUS) , 3001, 12e Avenue Nord, Sherbrooke, QC, J1H 5N4, Canada
| | - Warner Mbuila Mampuya
- Division of Cardiology, Department of Medicine, Sherbrooke University Hospital Center (CHUS) , 3001, 12e Avenue Nord, Sherbrooke, QC, J1H 5N4, Canada
| | - Étienne L Couture
- Division of Cardiology, Department of Medicine, Sherbrooke University Hospital Center (CHUS) , 3001, 12e Avenue Nord, Sherbrooke, QC, J1H 5N4, Canada
| | - Michel Nguyen
- Division of Cardiology, Department of Medicine, Sherbrooke University Hospital Center (CHUS) , 3001, 12e Avenue Nord, Sherbrooke, QC, J1H 5N4, Canada
| | - Btissama Essadiqi
- Division of Cardiology, Department of Medicine, Sherbrooke University Hospital Center (CHUS) , 3001, 12e Avenue Nord, Sherbrooke, QC, J1H 5N4, Canada
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Impact of the distribution of epicardial and visceral adipose tissue on left ventricular diastolic function. Heart Vessels 2021; 37:250-261. [PMID: 34228157 DOI: 10.1007/s00380-021-01904-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 07/02/2021] [Indexed: 12/28/2022]
Abstract
Although epicardial adipose tissue (EAT) and abdominal visceral adipose tissue (VAT) can contribute to left ventricular diastolic dysfunction (LVDD), the impact of these distribution has not been fully understood. A total of 235 patients who underwent cardiac computed tomography angiography and Doppler echocardiography was included in this study. We evaluated the association of indexed EAT volume and VAT area with septal and lateral early diastolic mitral annular velocity (e'). The VAT area index was significantly associated with septal and lateral e' velocity after adjusted for conventional cardiovascular risk factors and obstructive coronary artery disease (β-estimate; - 0.015 and - 0.019, both p = 0.01). The natural logarithmic EAT volume index (ln EAT volume index) also showed a significant association with septal and lateral e' (β-estimate; - 1.72 and - 0.99, both p < 0.01). The significant association of ln EAT volume index with septal and lateral e' was observed even after adjusting for VAT area index (β-estimate; - 0.79 and - 1.52, both p < 0.03). In the subgroup analysis, there were significant association of ln EAT volume index with both septal and lateral e' in the lower VAT group (β-estimate; - 1.40 and - 1.53, both p < 0.03) and with lateral e' in the higher VAT group (β-estimate - 1.64, p = 0.006). In contrast, ln EAT volume index was not associated with septal e' in the higher VAT group (p = 0.98). EAT accumulation was significantly associated with LVDD independently of obstructive coronary artery disease and abdominal VAT. The impact of EAT on LVDD may vary depending on the amount of abdominal VAT.
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Association of Exercise Capacity, Cardiac Function, and Coronary Artery Calcification with Components for Metabolic Syndrome. BIOMED RESEARCH INTERNATIONAL 2018; 2018:4619867. [PMID: 30402479 PMCID: PMC6193328 DOI: 10.1155/2018/4619867] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 09/20/2018] [Indexed: 12/26/2022]
Abstract
Purpose The purpose of this study was to investigate the association of exercise capacity, cardiac function, and coronary artery calcification (CAC) with components of metabolic syndrome in Korean adults. Method Medical records of healthy adults who underwent exercise tolerance test (ETT), coronary CT angiography (CTA), and echocardiography of the heart for cardiac health check-up were retrospectively reviewed. Patients who had a history of severe cardiovascular disease or could not perform ETT due to other musculoskeletal problems were excluded. Subjects were classified into groups based on the number of components for metabolic syndrome: no component (Group 1, n=90), 1, 2 components (Group 2, n=321), and 3 or more components (Group 3, n=154). Exercise capacity was assessed using the symptom-limited ETT, and CAC score was obtained using the coronary CTA and Agatston score. Cardiac structure and function were assessed using echocardiography. Results A total of 565 patients (mean (SD) age 59.5 (9.1), 340 men, 225 women) were selected. Exercise capacity was significantly lower in Group 3 than in the other groups (p<0.05). The CAC score was significantly higher in Group 3 than in the other groups (p<0.05). Compared to the other groups, echocardiography findings in Group 3 showed a greater hypertrophy of the left ventricle and reduction in the diastolic function (p<0.05). Exercise capacity, CAC score, cardiac structure, and function were different between the 3 groups, where a tendency to worsen was observed from Group 1 to Group 3. Conclusion Metabolic syndrome decreases exercise capacity of the patient and contributes to CAC, thereby increasing the risk for cardiovascular diseases and deterioration in cardiac structure and function. Therefore, early detection of metabolic syndrome and subsequently the prevention and management of heart disease are necessary.
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