Assessment of Right Ventricular Function in Metabolic Syndrome Patients with Tissue Doppler

Öz

Aim:  Metabolic syndrome is defined as a clinical entity characterized by insulin resistance, abdominal obesity, glucose intolerance or diabetes mellitus, dyslipidemia and hypertension.  In the present study, we aimed to evaluate right ventricular function in metabolic syndrome patients with tissue Doppler echocardiography.

Material and Method:  The study population consisted of 28 metabolic syndrome patients and sex-age matched 30 control subjects. All the study population underwent echocardiography and right ventricular function was assessed by tissue echocardiography.  

Results: The mean age of the metabolic syndrome patients was 48±6.7 and control group was 46±8.3 and there was no statistical significant difference.  When compared to the control group, right ventricular function assessed by tissue doppler was found to be significantly lower in metabolic syndrome patients (10.3±2.4 vs 16.4±3.6; p<0.001). Besides, early diastolic wave (Em) velocity, one of the important indicator of the diastolic function, was significantly lower in the metabolic syndrome group (8.3±3.1 vs 12.5±4.6; p<0.001).  Late diastolic wave (Am) velocity was found to be comparable between the groups (14.3±5.4 vs 15.7±5.8).  

Conclusion: Metabolic syndrome patients with normal left ventricular function had impaired right ventricular function assessed by tissue doppler echocardiography. 

Key Words: Metabolik syndrome, Right ventricle, Echocardiography

Anahtar Kelimeler

• Metabolik syndrome, Right ventricle, Echocardiography

Metabolik Sendromlu Hastalarda Sağ Ventrikül Fonksiyonlarının Doku Doppler Ekokardiyografi İle Değerlendirilmesi

Öz

Amaç: Metabolik sendrom, insülin direnciyle başlayan abdominal obezite, glukoz intoleransı veya diabetes mellitus, dislipidemi, hipertansiyon gibi aterosklerotik risk faktörlerini içeren klinik bir durum olarak tanımlanır. Bu çalışmamızda metabolik sendromlu hastalarda sağ ventrikül fonksiyonları doku Doppler ekokardiyografi ile değerlendirmeyi amaçladık.

Gereç ve Yöntem: Çalışmamıza 28 metabolik sendrom hastası ve hastalar ile yaş ve cinsiyet açısından eşitlenmiş 30 kontrol dahil edilmiştir.  Tüm çalışma grubuna ekokardiyografi yapılmış olup sol ventrikül fonksiyonları normal olan hastalarda sağ ventrikül fonksiyonları doku Doppler ile değerlendirilmiştir.

Bulgular: Metabolik sendrom hastalarının ortalama yaşı 48±6.7 olup kontrol grubunun yaş ortalaması ise 46±8.3’dü ve aralarındaki fark istatistiksel anlamlı değildi. Sağ ventrikül doku doppler sistolik dalga (Sm) değerleri metabolik sendrom hastalarında kontrol grubu ile karşılaştırıldığında anlamlı düşük saptandı (10.3±2.4 vs 16.4±3.6; p<0.001). Ayrıca diyastolik fonksiyonun önemli göstergelerinden olan erken diyastolik dalga (Em) velositesi metabolik sendrom hastalarında belirgin olarak düşük saptandı (8.3±3.1 vs 12.5±4.6; p<0.001). Geç diyastolik dalga (Am) velositesi ise iki grup arasında benzer saptandı (14.3±5.4 vs 15.7±5.8).  

Sonuç: Sol ventrikül sistolik fonksiyonu normal olan metabolik sendrom hastalarda doku doppler ekokardiyografi ile değerlendirilen sağ ventrikül fonksiyonlarının bozulmuştur.

Anahtar Kelimeler: Metabolik sendrom, Sağ ventrikül, Ekokardiyografi

Anahtar Kelimeler

• Metabolik sendrom, Sağ ventrikül, Ekokardiyografi

Kaynakça

1. Metabolik Sendrom Kılavuzu. Türkiye Endokrinoloji ve Metabolizma Derneği 2009.
2. Iacobellis G, Ribaudo MC, Leto G, Zappaterreno A, Vecci E, Di Mario U, et al. Influence of excess fat on cardiac morphology and function: study in ucomplicated obesity. Obes Res 2002;10:767-73.
3. Engeli S, Sharma AM. The renin-angiotensin system and natriuretic peptides in obesity-associated hypertension. J Mol Med 2001;79:21-9.
4. Vincent HK, Powers SK, Steward DJ, Shanely RA, Demirel H, Naito H. Obesity is associated with increased myocardial oxidative stres. Int J Obes Relat Metab Disord 1999;23:67-74.
5. Devereux RB, Roman MJ, Paranicas M, O’Grady MJ, Lee ET, Welty TK, et al. Impact of diabetes on cardiac structure and function: the strong heart study. Circulation 2000;101:2271-76.
6. Tadic M, Ivanovic B, Kostic N, Simic D, Matic D, Celic V. Metabolic syndrome and left ventricular function: is the number of criteria actually important? Med Sci Monit 2012;18(5):282-9.
7. Paneni F, Gregori M, Tocci G, Palano F, Ciaverella GM, Pignatelli G, et al. Do diabetes, metabolic syndrome or their association equally affect biventricular function? A tisue doppler study. Hypertens Res 2013;36(1):36-42.
8. Voulgari C, Tentolouris N, Dilaveris P, Tousoutis D, Katsi Lambros N, Stefanadis C. Increased heart failure risk in normal weight people with metabolic syndrome compared with metabolically health obese individuals. Jurnal of the American College of Cardiology 2011;58 (13):1343-50.

9. Vyssoulis G, Karpanou E, Adamopoulos D, Kyvelou SM, Tzamou V, Michaelidis A, et al. Metabolic syndrome and atrial fibrillation in patients with essential hypertension. Nutrition, Metabolism. Cardiovascular Disease 2011;1-6.
10. Tadic M, Ivanovic B, Grozdic I. Metabolic syndrome impacts the right ventricle; true or false? Echocardiography 2011;28(5):530-8.
11. Karakurt Ö, Öztekin S, Yazıhan N, Akdemir R. Impaired right ventricular functions in metabolic syndrome patients with preserved left ventricular ejection fraction. Türk Kardiyol Der Arş 2011;39(7):549-56.
12. Rudski LG, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K, et al. Guidelines fort he echocardiographic assessment of the right heart in adults: A report from the American Society of Echocardiogaraphy. Journal of the American Society of Echocardiography 2010;23:685-713.
13. Meluzín J, Spinarová L, Bakala J, Toman J, Krejcí J, Hude P, et al. Pulsed Doppler tissue imaging of the velocity of tricuspit annuler systolic motion. Eur Heart J 2001;22:340-48.