Revista de síndrome metabólico

Predictors of Left Ventricular Diastolic Dysfunction in Metabolic Syndrome: Gender Differences

Abstract

Ewa Kruszynska, Michaela Kozakova, Maria Loboz Rudnicka, Carmela Morizzo, Carlo Palombo, Krystyna Loboz Grudzien and Joanna Jaroch

Background: Little is known about the sex-specific differences in predictors of left ventricular diastolic dysfunction in metabolic syndrome. One of the novel paradigms include the role of arterial stiffness in the pathogenesis of left ventricular diastolic dysfunction. There are some differences in arterial stiffness in patients with metabolic syndrome. We hypothesized that arterial stiffness may play a different role in the etiology of diastolic dysfunction in men and women with metabolic syndrome, acting independently from other established predictors of this condition besides the components of metabolic syndromes, such as age, left ventricular hypertrophy and systolic function. The aim of the study was to analyze the sex-specific differences in arterial stiffness as predictors of diastolic dysfunction in metabolic syndrome.
Methods: The study included 131 patients from 2 centers in Poland and Italy (60 women and 71 men, mean age 53.7 ± 6.7 years) with metabolic syndrome and no history of cardiovascular disease. All patients underwent detailed echocardiography and high-resolution echo-tracking of carotid arteries with the evaluation of arterial stiffness.
Results: In the multivariate analysis, relative wall thickness was independently associated with diastolic dysfunction occurrence in women with metabolic syndrome (P=0.012), while independent predictors of diastolic dysfunction in men were relative wall thickness (P=0.08), left ventricular mass index (P=0.001) and arterial compliance (P=0.004).
Conclusions: There are sex-differences in left ventricular diastolic dysfunction predictors in metabolic syndrome. Besides left ventricular hypertrophy as a powerful determinant of left ventricular diastolic dysfunction in both men and women with metabolic syndrome, also arterial compliance as a measure of arterial stiffness was independently associated with left ventricular diastolic dysfunction occurrence in men but not in women with metabolic syndrome.