Abstract
Background
We sought to investigate right ventricular (RV) and right atrial (RA) deformation
obtained using 3-dimensional echocardiography (3DE) and 2-dimensional (2DE) strain
in subjects with the metabolic syndrome (MS).
Methods
This cross-sectional study included 108 untreated subjects with the MS and 75 control
subjects similar according to sex and age. The MS was defined by the presence ≥ 3
American Heart Association/National Heart, Lung, and Blood Institute criteria. All
the subjects underwent adequate laboratory analyses and complete 2DE and 3DE examination.
Results
2DE global longitudinal strain of the RV was significantly decreased in the MS group
compared with the control subjects (−24 ± 5 vs −27 ± 5%; P < 0.001). Similar results were obtained for the RA longitudinal strain (40 ± 5 vs
44 ± 7%; P < 0.001). Systolic and early diastolic RV and RA strain rates were decreased, whereas
late diastolic strain rates were increased among the MS participants compared with
the control subjects. 3DE RV ejection fraction was significantly decreased in the
MS subjects (55 ± 4 vs 58 ± 4%; P < 0.001). The multivariate analysis of MS criteria showed that systolic blood pressure,
waist circumference, and fasting glucose were independently associated with RV and/or
RA myocardial function and deformation.
Conclusions
RV mechanics and RA mechanics, assessed using 3DE and 2DE strain, were significantly
deteriorated in the MS subjects. Among all MS risk factors, systolic blood pressure,
abdominal circumference, and fasting glucose were the most responsible for the right
heart remodelling.
Résumé
Introduction
Nous avons cherché à examiner la déformation du ventricule droit (VD) et de l’oreillette
droite (OD) obtenue au moyen de l’échocardiographie tridimensionnelle (échocardiographie
3D) strain et de l’échocardiographie bidimensionnelle (échocardiographie 2D) strain chez les sujets ayant un syndrome métabolique (SM).
Méthodes
Cette étude transversale incluait 108 sujets non traités qui souffraient d’un SM et
75 sujets témoins similaires selon le sexe et l’âge. Le SM a été défini par la présence
≥ 3 critères selon l’American Heart Association et le National Heart, Lung, and Blood
Institute. Tous les sujets ont subi des analyses de laboratoire appropriées et un
examen complet en échocardiographie 2D et en échocardiographie 3D.
Résultats
L’échocardiographie 2D strain longitudinale globale du VD a été significativement diminuée chez le groupe ayant
un SM comparativement aux sujets témoins (−24 ± 5 vs −27 ± 5 %; P < 0,001). Des résultats similaires ont été obtenus par le strain longitudinal de l’OD (40 ± 5 vs 44 ± 7 %; P < 0,001). Les vitesses de déformation systolique et diastolique précoce du VD et
de l’OD ont été diminuées, tandis que les vitesses de déformation diastolique tardive
ont été augmentées chez les participants ayant un SM comparativement aux sujets témoins.
La fraction d’éjection du VD à l’échocardiographie 3D a été significativement diminuée
chez les sujets ayant un SM (55 ± 4 vs 58 ± 4 %; P < 0,001). L’analyse multivariée des critères du SM a montré que la pression artérielle
systolique, le tour de taille et la glycémie à jeun étaient indépendamment associés
au fonctionnement et à la déformation myocardiques du VD ou de l’OD, ou du VD et de
l’OD.
Conclusions
Le mécanisme du VD et le mécanisme de l’OD évalués au moyen de l’échocardiographie
3D strain et l’échocardiographie 2D strain ont été significativement détériorés chez les sujets ayant un SM. Parmi tous les
facteurs de risque liés au SM, la pression artérielle systolique, le tour de taille
et la glycémie à jeun ont été les principaux responsables du remodelage du cœur droit.
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Article info
Publication history
Published online: December 19, 2013
Accepted:
December 8,
2013
Received:
November 14,
2013
Footnotes
See editorial by Fitchett and Connelly on pages 270-271 and article by Crendal et al. on pages 320-324 of this issue.
See page 329 for disclosure information.
Identification
Copyright
© 2014 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
