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
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 E-mail: firstname.lastname@example.org