3D echocardiography: "The most powerful predictor of masked CVD in metabolic syndrome"

Academic Article

Abstract

  • Aims & Objective: To evaluate the impact of the Metabolic Syndrome (MS) on various echo variables by 3D echocardiography. Materials and methods: 100 patients of MS from indoor and outdoor patient departments were subjected to Echocardiographic and Carotid Doppler evaluation. They were divided into three groups: Group A, Group B and Group C on the basis of age < 40 yrs, 40-60 yrs and > 60 yrs respectively. The echo variables included left ventricular myocardial performance index (LVMPI), left ventricular mass index (LVMi), left ventricular diastolic dysfunction (LVDD), systolic function (LVEF), left atrial volume index (LAVi) and composite common carotid intima media thickness (CCIMT). Results: The mean LVMPI was abnormal in all the groups and showed an increasing trend with prolonged LVMPI (> 0.4) in 74% of the total population. Prolonged LVMPI in Group A, Group B and Group C was 12.1%, 52.7 % and 35.1% respectively. There was also a strong correlation between LVMPI & LVDD (p-value < 0.0001). The mean LVEF was normal in all the groups with only 9 % had systolic dysfunction (LVEF < 50%). 68% had abnormal diastolic function, of which 53 % had grade I LVDD, 12 % had grade II LVDD and 3 % had grade III diastolic dysfunction. None of our patients had grade IV diastolic dysfunction. The mean LAVi was normal in all the groups, but LAVi increased with worsening LVDD. The mean LVMI indexed to Body Surface Area (BSA) was normal in all the groups, but showed a statistically significant increasing trend from Group A to Group C (p-value < 0.05). Statistically significant higher LVMI values were observed for males as compared to females (p value < 0.0001). On analysis of patients having left ventricular hypertrophy (LVH), 76% had concentric remodelling; only 11 % had concentric hypertrophy, but none had eccentric hypertrophy. Most of our patients in Group B & Group C had higher mean Composite CCIMT (0.73 ± 0.33 & 0.84 ± 0.42 respectively) which was statistically very significant (p-value <0.001) Conclusion: Metabolic Syndrome is associated with masked CVD as evident by 3D Echo in our series of patients. LVMPI was an early indicator and most robust marker of early LVDD. Impaired relaxation was highly prevalent; while on the contrary LAVI was less robust predictor of LVDD in our series of patients. Concentric left ventricular remodeling was the most common pattern of LVH. Most of our series of patients had increased Composite CCIMT. Thus 3D Echocardiography has a great potential and is very useful for early detection and timely therapeutic interventions in patients with subclinical CVD in MS.
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    Author List

  • Chopra HK; Aggarwal KK; Krishna CK; Sambi RS; Parashar SK; Gupta R; Kasliwal RR; Mittal S; Bansal M; Gaur AK
  • Start Page

  • 231
  • End Page

  • 241
  • Volume

  • 61
  • Issue

  • 3