Revista de síndrome metabólico

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.

Type 2 Diabetes Mellitus patients are predisposed to serious cardiovascular morbidity and mortality. Diabetes causes different structural and functional alterations in the myocardial tissue, which are induced by hyperglycemia, insulin resistance, and hyperlipidemia. The resulting cardiomyopathy is characterized by myocardial fibrosis, dysfunctional remodeling and eventually, clinical heart failure. This study addressed the effects of resveratrol and pioglitazone to ameliorate diabetic cardiovascular complications using a db/db diabetic mice model. Male db/db diabetic mice were randomly assigned to orally receive resveratrol (50 mg/kg, n=5), resveratrol/pioglitazone (50 mg/kg and 20 mg/day, respectively, n=5) for the space of 6 weeks. Non-diabetic lean mice (n=5) were included as a control group. Histopathological analyses were performed in heart and aortic vessel tissue samples using hematoxylin and eosin, as well as Masson Trichromic staining. VCAM-1 immunohistochemistry was also assessed. Blood glucose, hemoglobin A1c, insulin, glycosuria, triglycerides, cholesterol, and LDL cholesterol were all examined. Present data suggest that the combination of pioglitazone plus resveratrol significantly lower circulating levels of insulin, hemoglobin A1c, glucose, triglycerides, cholesterol, and LDL levels. Our results also show that tissue damage to the heart and aortic vessels caused by diabetes can also be improved by the administration of said combination. The present study demonstrates that resveratrol/pioglitazone combination therapy improves carbohydrate and lipid metabolism, as well as improving diabetic cardiomyopathy in diabetic mice by producing a synergistic pharmacological effect. The combination of resveratrol plus pioglitazone has therapeutic potential against diabetic cardiomyopathy.