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Hypertension Research
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Left Ventricular Diastolic Dysfunction as Assessed by Echocardiography in Metabolic Syndrome
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  • Original Article
  • Published: 01 November 2006

Left Ventricular Diastolic Dysfunction as Assessed by Echocardiography in Metabolic Syndrome

  • Hisashi Masugata1,
  • Shoichi Senda1,
  • Fuminori Goda1,
  • Yumiko Yoshihara2,
  • Kay Yoshikawa2,
  • Norihiro Fujita2,
  • Hiroyuki Daikuhara2,
  • Hiroyuki Nakamura2,
  • Teruhisa Taoka2 &
  • …
  • Masakazu Kohno3 

Hypertension Research volume 29, pages 897–903 (2006)Cite this article

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Abstract

The purpose of the present study was to elucidate the cardiac structure and function in patients who have metabolic syndrome but no history of cardiovascular disease by analyzing echocardiographic findings. Echocardiographic examination was performed to screen for cardiovascular disease in 135 patients who were in their sixties. Patients were divided into metabolic syndrome (n=65, age: 65±2.7 years) and non–metabolic syndrome (n=70, age: 66±2.5 years) groups based on the criteria for metabolic syndrome proposed by the Japanese Society of Hypertension and seven other societies in 2005. The left ventricular (LV) wall thickness and dimension were measured by M-mode echocardiography. The relative wall thickness, LV mass index, and LV ejection fraction (LVEF) were calculated. LV diastolic function was assessed by the peak velocity of early rapid filling (E velocity) and the peak velocity of atrial filling (A velocity), and the ratio of E to A (E/A) was assessed by the transmitral flow. The Tei index, which reflects both LV diastolic and systolic function, was also calculated. There were no differences in relative wall thickness, LV mass index, or LVEF between the two groups. However, both the E/A and Tei index were significantly different between the metabolic syndrome (0.66±0.14 and 0.36±0.07, respectively) and non–metabolic syndrome (0.88±0.25 and 0.29±0.09) groups (p<0.001). These results indicate that patients with metabolic syndrome can have cardiac diastolic dysfunction even if they have neither LV hypertrophy nor systolic dysfunction.

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References

  1. Hunt SA, Abraham WT, Chin MH, et al: ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult—summary article. Circulation 2005; 112: 1825–1852.

    Article  Google Scholar 

  2. Lakka HM, Laaksonen DE, Lakka TA, et al: The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA 2002; 288: 2709–2716.

    Article  PubMed  Google Scholar 

  3. Takeuchi H, Saitoh S, Takagi S, et al: Metabolic syndrome and cardiac disease in Japanese men: applicability of the concept of metabolic syndrome defined by the National Cholesterol Education Program–Adult Treatment Panel III to Japanese men—the Tanno and Sobetsu Study. Hypertens Res 2005; 28: 203–208.

    Article  PubMed  Google Scholar 

  4. Tsubakimoto A, Saito I, Mannami T, et al: Impact of metabolic syndrome on brachial-ankle pulse wave velocity in Japanese. Hypertens Res 2006; 29: 29–37.

    Article  PubMed  Google Scholar 

  5. Nakanishi N, Shiraishi T, Wada M : Brachial-ankle pulse wave velocity and metabolic syndrome in a Japanese population: the Minoh study. Hypertens Res 2005; 28: 125–131.

    Article  PubMed  Google Scholar 

  6. Ishizaka N, Ishizaka Y, Toda E, Hashimoto H, Nagai R, Yamakado M : Hypertension is the most common component of metabolic syndrome and the greatest contributor to carotid arteriosclerosis in apparently healthy Japanese individuals. Hypertens Res 2005; 28: 27–34.

    Article  PubMed  Google Scholar 

  7. Imai Y, Otsuka K, Kawano Y, et al: Japanese Society of Hypertension (JSH) guidelines for self-monitoring of blood pressure at home. Hypertens Res 2003; 26: 771–782.

    Article  PubMed  Google Scholar 

  8. Japan Diabetes Society : Guidelines for diagnosis of diabetes mellitus. J Jpn Diabetes Soc 1999; 42: 385–404.

  9. Hata Y, Mabuchi H, Saito Y, et al: Report of the Japan Atherosclerosis Society (JAS) guideline for diagnosis and treatment of hyperlipidemia in Japanese adults. J Atheroscler Thromb 2002; 9: 1–27.

    Article  PubMed  Google Scholar 

  10. Examination Committee of Criteria for Metabolic Syndrome : Definition and criteria for metabolic syndrome. J Jpn Soc Intern Med 2005; 94: 794–809 ( in Japanes).

  11. Sahn DJ, DeMaria A, Kisslo J, Weyman A : Recommendations regarding quantitation in M-mode echocardiography: results of a survey of echocardiographic measurements. Circulation 1978; 58: 1072–1083.

    Article  CAS  PubMed  Google Scholar 

  12. Schiller NB, Shah PM, Crawford M, et al: Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. J Am Soc Echocardiogr 1989; 2: 358–367.

    Article  CAS  PubMed  Google Scholar 

  13. Devereux RB, Wallerson DC : Reproducibility of echocardiographic left ventricular measurements. Hypertension 1987; 9 ( Suppl II): II-6–II-18.

    Google Scholar 

  14. Patel CD, Nadig MR, Kurien S, Barai S, Narang R, Malhotra A : Left ventricular ejection fraction and volumes on rest gated 201Tl perfusion SPECT: comparison with two-dimensional echocardiography. Nucl Med Commun 2006; 27: 425–429.

    Article  PubMed  Google Scholar 

  15. Appleton CP, Firstenberg MS, Garcia MJ, Thomas JD : The echo-Doppler evaluation of left ventricular diastolic function. A current perspective. Cardiol Clin 2000; 18: 513–546.

    Article  CAS  PubMed  Google Scholar 

  16. Poerner TC, Goebel B, Unglaub P, et al: Detection of a pseudonormal mitral inflow pattern: an echocardiographic and tissue Doppler study. Echocardiography 2003; 20: 345–356.

    Article  PubMed  Google Scholar 

  17. Tei C, Ling LH, Hodge DO, et al: New index of combined systolic and diastolic myocardial performance: a simple and reproducible measure of cardiac function—a study in normals and dilated cardiomyopathy. J Cardiol 1995; 26: 357–366.

    CAS  PubMed  Google Scholar 

  18. Tei C, Dujardin KS, Hodge DO, Kyle RA, Tajik AJ, Seward JB : Doppler index combining systolic and diastolic myocardial performance: clinical value in cardiac amyloidosis. J Am Coll Cardiol 1996; 28: 658–664.

    Article  CAS  PubMed  Google Scholar 

  19. Wong CY, O'Moore-Sullivan T, Fang ZY, Haluska B, Leano R, Marwick TH : Myocardial and vascular dysfunction and exercise capacity in the metabolic syndrome. Am J Cardiol 2005; 96: 1686–1691.

    Article  PubMed  Google Scholar 

  20. Grandi AM, Maresca AM, Giudici E, et al: Metabolic syndrome and morphofunctional characteristics of the left ventricle in clinically hypertensive nondiabetic subjects. Am J Hypertens 2006; 19: 199–205.

    Article  PubMed  Google Scholar 

  21. Zile MR, Brutsaert DL : New concepts in diastolic dysfunction and diastolic heart failure: Part II. Causal mechanisms and treatment. Circulation 2002; 105: 1503–1508.

    Article  PubMed  Google Scholar 

  22. Scognamiglio R, Avogaro A, Negut C, et al: Early myocardial dysfunction in the diabetic heart: current research and clinical applications. Am J Cardiol 2004; 93 ( 8A): 17A–20A.

    Article  CAS  PubMed  Google Scholar 

  23. Mizushige K, Yao L, Noma T, et al: Alteration in left ventricular diastolic filling and accumulation of myocardial collagen at insulin-resistant prediabetic stage of a type II diabetic rat model. Circulation 2000; 101: 899–907.

    Article  CAS  PubMed  Google Scholar 

  24. Bajraktari G, Koltai MS, Ademaj F, et al: Relationship between insulin resistance and left ventricular diastolic dysfunction in patients with impaired glucose tolerance and type 2 diabetes. Int J Cardiol 2006; 110: 206–211.

    Article  PubMed  Google Scholar 

  25. Horio T, Suzuki M, Suzuki K, et al: Pioglitazone improves left ventricular diastolic function in patients with essential hypertension. Am J Hypertens 2005; 18: 949–957.

    Article  CAS  PubMed  Google Scholar 

  26. Roman MJ, Ganau A, Saba PS, Pini R, Pickering TG, Devereux RB : Impact of arterial stiffening on left ventricular structure. Hypertension 2000; 36: 489–494.

    Article  CAS  PubMed  Google Scholar 

  27. Moulopoulos SD, Stamatelopoulos SF, Zakopoulos NA, et al: Effect of 24-hour blood pressure and heart rate variations on left ventricular hypertrophy and dilation in essential hypertension. Am Heart J 1990; 119: 1147–1152.

    Article  CAS  PubMed  Google Scholar 

  28. Aeschbacher BC, Hutter D, Fuhrer J, Weidmann P, Delacretaz E, Allemann Y : Diastolic dysfunction precedes myocardial hypertrophy in the development of hypertension. Am J Hypertens 2001; 14: 106–113.

    Article  CAS  PubMed  Google Scholar 

  29. Chang NC, Lai ZY, Wang TC : Enalapril does not improve left ventricular diastolic dysfunction in young and mild hypertensives without concomitant hypertrophy. Am J Hypertens 1996; 14: 909–914.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Integrated Medicine, Kagawa University, Kagawa, Japan

    Hisashi Masugata, Shoichi Senda & Fuminori Goda

  2. Department of Internal Medicine, Sakaide Municipal Hospital, Sakaide, Japan

    Yumiko Yoshihara, Kay Yoshikawa, Norihiro Fujita, Hiroyuki Daikuhara, Hiroyuki Nakamura & Teruhisa Taoka

  3. Department of CardioRenal and Cerebrovascular Medicine, Kagawa University, Kagawa, Japan

    Masakazu Kohno

Authors
  1. Hisashi Masugata
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  2. Shoichi Senda
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Correspondence to Hisashi Masugata.

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Masugata, H., Senda, S., Goda, F. et al. Left Ventricular Diastolic Dysfunction as Assessed by Echocardiography in Metabolic Syndrome. Hypertens Res 29, 897–903 (2006). https://doi.org/10.1291/hypres.29.897

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  • Received: 07 April 2006

  • Accepted: 28 July 2006

  • Issue date: 01 November 2006

  • DOI: https://doi.org/10.1291/hypres.29.897

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Keywords

  • metabolic syndrome
  • cardiac function
  • echocardiography

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