Am J Cardiovasc Dis 2011;1(1):84-91

Original Article
Relation of components of the metabolic syndrome to left ventricular
geometry in Hispanic and Non-Hispanic black adults

Teimuraz Apridonidze, Hussein Shaqra, Nessrine Ktaich, Jennifer E. Liu, Jonathan N. Bella

Division of Cardiology, Department of Medicine, Bronx-Lebanon Hospital Center, Bronx, NY, Memorial Sloan Kettering
Cancer Center, New York, NY and Albert Einstein College of Medicine, Bronx, NY.

Received May 6, 2011; accepted May 16, 2011; Epub May 19, 2011; published June 1, 2011

Abstract: Background: Left ventricular (LV) hypertrophy is an independent predictor of increased cardiovascular morbidity
and mortality.  It remains unclear whether components of the metabolic syndrome are associated with LV hypertrophy.
Methods and Results:  Accordingly, we analyzed echocardiograms in 192 consecutive ambulatory patients referred for
echocardiography from October to December 2004.  Patients were excluded if they had atrial fibrillation, significant valvular
heart disease or failed to cooperate for echocardiogram.  Of these, 126 (66%) patients met Adult Treatment Panel (ATP) III
diagnostic criteria for the metabolic syndrome.  29% had any 3 metabolic syndrome components, 18% had any 4
metabolic syndrome components and 17% had all 5 metabolic syndrome components.  In analyses of variance adjusted
for age and sex, LV mass and LV mass adjusted to its allometric relation to height2.7  (LV mass/height2.7) were higher in
patients with metabolic syndrome compared to those without metabolic syndrome  (237 g [228-239 95%CI] vs. 224 g
[206-239 95%CI] p=0.005 and 62 g/m2.7 [59-65 95%CI] vs. 56 g/m2.7 [52-60 95%CI] p=0.014, respectively). The
prevalence of LV hypertrophy using prognostically-validated gender-specific partition values for LV mass/ height2.7 was  
significantly higher in metabolic syndrome patients than in those without metabolic syndrome (81 v. 58%, p<0.001). There
was a step-wise increase in LV mass/ height2.7 in those with no metabolic syndrome components to those with
increasing number of metabolic syndrome components (Figure, p<0.001). In this study of high-risk patients, the significant
independent predictors of LV hypertrophy were only high blood pressure (OR=3.2, p=0.008) and increased waist
circumference (OR=2.8, p=0.006) with no interaction between blood pressure and waist circumference. Conclusion:  
Metabolic syndrome is associated with higher LV mass and prevalence of LV hypertrophy.  Increasing number of metabolic
syndrome components is associated with step-wise increases in LV mass.  Identification of LV hypertrophy in metabolic
syndrome patients may provide an additional prognostic tool to further risk-stratify these patients. (AJCD1105002).

Keywords: Metabolic syndrome, hypertension, left ventricle, hypertrophy, abdominal obesity

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Address all correspondence to:
Jonathan N. Bella, MD
Bronx-Lebanon Hospital Center
Division of Cardiology
1650 Grand Concourse, 12th Floor
Bronx, NY 10457
Tel:  (718) 518-522, Fax:  (718) 518-5585         
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