The Effects of Metabolic Syndrome on Aortic Distensibility in Patients with Angiographically Normal Coronary Arteries

Year 2013, Volume: 3 Issue: 4, 195 - 200, 01.12.2013

Ali Emül Kemal Karaağaç Zeynel Abidin Yetgin Hakan Uçar İbrahim Baran Ali Aydınlar

https://doi.org/10.5505/sakaryamj.2013.69672

Abstract

Objective: In this study we aimed to investigate the parameters of aortic stiffness that were measured angiographically and the factors that effect these parameters in patients diagnosed as having metabolic syndrome and whose coronary arteries were normal angiographically. Materials and Methods: Thirty patients with metabolic syndrome and twenty patients without metabolic syndrome were included. Hemodynamic measurements were made during cardiac catheterization while the patients were in supine position. The systolic and diastolic diameters of aorta and parameters associated with aortic stiffness aortic strain and distensibility were measured.Results: When compared with the control group the systolic and diastolic blood pressure, pulse pressure, waist circumference, triglyceride and fasting plasma glucose levels were higher and HDL cholesterol level was lower in the metabolic syndrome group. Aortic strain was higher in the metabolic syndrome group but the statistical relation was non-significant (p=0,181). Moreover the distensibility was lower in the metabolic syndrome group and the statistical relation was significant (p

Keywords

Metabolic syndrome, aortic function, arterial stifness

Koroner Arterler Normal Olan Hastalarda Metabolik Sendromun Aortik Distensibilite Üzerine Etkisi

Abstract

Amaç: Bu çalışmada, metabolik sendrom tanısı alan ve anjiyografik olarak koroner arterleri normal saptanan hastalarda metabolik sendromun invazif olarak ölçülmüş aort sertlik parametrelerine olan etkilerini ortaya koymayı amaçladık.Gereç ve Yöntemler: Çalışmaya metabolik sendrom tanısı konan 30 hasta ve kontrol grubu olarak metabolik sendrom tanısı bulunmayan 20 hasta alındı. Hemodinamik ölçümler hasta yatar pozisyonda kardiyak kateterizasyon yapımı esnasında değerlendirildi. Aort sistolik ve diyastolik çapları ölçüldü ve aort sertliğinin göstergeleri olan aort gerilimi ve esneyebilirliği hesaplandı.Bulgular: Metabolik sendrom grubunda, kontrol grubu ile karşılaştırıldığında beklendiği üzere sistolik ve diyastolik kan basıncı, nabız basıncı, bel çevresi, trigliserid düzeyi, açlık kan şekeri değerleri daha yüksek, HDL-kolesterol düzeyleri düşük bulundu. Metabolik sendrom grubunda aort gerilimi istatistiksel olarak anlamlı olmamakla birlikte daha yüksek saptandı(p=0.181). Aort esneyebiliriği ise istatistiksel olarak anlamlı olarak daha düşük idi(p

Keywords

Metabolik sendrom, aortik fonksiyon, arteryel sertlik

References

• Reaven GM: Banting lecture 1988: Role of insulin resistance in human disease. Diabetes 1988;37(12):1595-1607.
• Isomaa B, Almgren P, Tuomi T, Forsén B, Lahti K, Nissén M, et al.: Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 2001;24(4):683-9.
• Lorenzo C, Okoloise M, Williams K, Stern MP, Haffner SM, San Antonio Heart Study: The metabolic syndrome as predictor of type 2 diabetes: the San Antonio heart study. Diabetes Care 2003;26(11):3153-59.
• McNeill AM, Rosamond WD, Girman CJ, Heiss G, Golden SH, Duncan BB, et al: Prevalence of coronary heart disease and carotid arterial thickening in patients with the metabolic syndrome (The ARIC Study). Am J Cardiol 2004;94(10):1249-54.
• Czernichow S, Bertrais S, Blacher J, Oppert JM, Galan P, Ducimetière P, et al. Metabolic syndrome in relation to structure and function of large arteries: a predominant effect of blood pressure. A report from the SU.VI.MAX. Vascular Study. Am J Hypertens 2005;18(9 Pt 1):1154-60.
• Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. JAMA 2001;285(19): 2486-97.
• Haffner SM, Miettinen H, Stern MP. The homeostasis model in San Anıtonio Heart Study. Diabetes Care 1997; 20(7): 1087-92.
• Lacombe F, Dart A, Dewar E, Jennings G, Cameron J, Laufer E. Arterial elastic properties in man: a comparison of echo-Doppler indices of aortic stiffness. Eur Heart J 1992;13(8):1040-5.
• Girman CJ, Rhodes T, Mercuri M, Pyörälä K, Kjekshus J, Pedersen TR, et al. The metabolic syndrome and risk of major coronary events in the Scandinavian Simvastatin Survival Study (4S) and the Air Force/ Texas Coronary Atherosclerosis Prevention Study. Am J Cardiol 2004; 93(2): 136- 41.
• Ford ES. The metabolic syndrome and mortality from cardiovascular disease and all-causes: findings from the National Health and Nutrition Examination Survey II Mortality Study. Atherosclerosis 2004; 173(2):309–14.
• Liao D, Arnett DK, Tyroler HA, Riley WA, Chambless LE, Szklo M, et al. Arterial stiffness and the development of hypertension. The ARIC study. Hypertension 1999;34(2): 201–6.
• Laurent S, Boutouyrie P, Asmar R, Gautier I, Laloux B, Guize L, et al. Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients. Hypertension 2001;37(5): 1236–41
• Scuteri A, Najjar SS, Muller DC, Andres R, Hougaku H, Metter EJ, et al. Metabolic syndrome amplifies the age-associated increases in vascular thickness and stiffness. J Am Coll Cardiol 2004;43(8): 1388–95.
• Safar ME, Thomas F, Blacher J, Nzietchueng R, Bureau JM, Pannier B, et al. Metabolic syndrome and age related progression of aortic stiffness. J Am Coll Cardiol 2006;47(1): 72–5.
• Asman G, Sculte H, Seedorf U. The Prospective Cardiovascular Munster (PROCAM) Study: Prevalence of hiperlipidemia in persons with hypertension and/ or diabetes mellitus and the relationship to coronary heart disease. Am Heart J 1998; 116(6 Pt 2): 1713- 24.
• Stehouwer CD, Henry RM, Ferreira I. Arterial stiffness in diabetes and the metabolic syndrome: a pathway to cardiovascular disease. Diabetologia 2008; 51(4): 527–39.
• Li S, Chen W, Srinivasan SR. et al. Influence of metabolic syndrome on arterial stiffness and its age related change in young adults: the Bogalusa Heart Study. Atherosclerosis 2005;180(2):349–54.
• Schillaci G, Pirro M, Vaudo G, Mannarino MR, Savarese G, Pucci G, et al. Metabolic syndrome is associated with aortic stiffness in untreated essential hypertension. Hypertension 2005;45(6): 1078–82.
• Ferreira I, Henry RM, Twisk J W. van Mechelen W, Kemper HC, Stehouwer CD, et al. The metabolic syndrome, cardiopulmonary fitness, and subcutaneous trunk fat as independent determinants of arterial stiffness: the Amsterdam Growth and Health Longitudinal Study. Arch Intern Med 2005;165(8):875–82.
• Stefanadis C, Dernellis J, Vlachopoulos C, Tsioufis C, Tsiamis E, Toutouzas K, et al. Aortic function in arterial hypertension determined by pressure-diameter relation: effects of diltiazem. Circulation 1997;96(6):1853-8.
• Lacombe F, Dart A, Dewar E, Jennings G, Cameron J, Laufer E. Arterial elastic properties in man: a comparison of echo-Doppler indices of aortic stiffness. Eur Heart J 1992;13(8):1040-5.
• Wolf AM, Colditz GA. Current estimates of the economic cost of obesity in the United States. Obes. Res. 1998; 6(2): 97–106
• Vardan S, Smulyan H, Mookherjee S, Hill NE, Gens J, Willsey GA. Importance of intraarterial blood pressure measurement in the evaluation of a new antihypertensive agent and the need to define hypertension also by this method. Ann J Hypertens 1990;3(11): 901–2.
• Sutton Tyrrell K, Newman A, Simonsick EM, Havlik R, Pahor M, Lakatta E, et al. Aortic stiffness is associated with visceral adiposity in older adults enrolled in the study of health, aging, and body composition. Hypertension 2001; 38(3): 429 -33
• Westerbacka J, Vehkavaara S, Bergholm R, Wilkinson I, Cockcroft J, Yki-Jarvinen H. Marked resistance of the ability of insulin to decrease arterial stiffness characterizes human obesity. Diabetes 1999;48(4):821-7.
• Protogerou AD, Blacher J, Aslangul E, Le Jeunne C, Lekakis J, Mavrikakis M, et al. Gender influence on metabolic syndrome’s effects on arterial stiffness and pressure wave reflections in treated hypertensive subjects. Atherosclerosis 2007;193(1):151– 8.