Key result
High hemoglobin linked to impaired LVGLS versus normal levels in metabolic syndrome.
Why the study?
Higher hemoglobin levels are associated with metabolic syndrome and LV dysfunction in the general population, but their associations with LV global strains in patients with metabolic syndrome remained to be assessed.
Are higher hemoglobin levels associated with impaired left ventricular global strains in patients with metabolic syndrome?
Observational (n=332)
No
Are higher hemoglobin levels associated with impaired left ventricular global strains in patients with metabolic syndrome?
Effect estimate: β -2.797 (95% CI -4.049 to -1.546)
p-value: p=<0.05
In patients with metabolic syndrome, hemoglobin levels above 143 g/L are associated with subclinical left ventricular dysfunction as measured by CMR feature tracking, particularly in those with obesity.
May flag subclinical LV dysfunction in metabolic syndrome; hypothesis-generating, does not support practice change.
BACKGROUND: Metabolic syndrome (MetS) is a known contributor to increased cardiovascular risk and all-cause mortality. Recent literatures suggested that higher hemoglobin (Hb) levels were associated with Mets, left ventricular (LV) dysfunction and adverse events in general population. This study aimed to assess the associations between Hb levels and LV global strains in patients with MetS. METHODS: A retrospective analysis included 254 patients with MetS and 78 sex-, age-, and Hb-matched controls. The MetS patients were stratified into five groups based on Hb levels: anemia, low-normal Hb, moderate-normal Hb, high-normal Hb, and high Hb. LV global radial, circumferential, and longitudinal strains (LVGRS, LVGCS, and LVGLS, respectively) were measured using the cardiac magnetic resonance feature tracking technique. Associations between Hb levels and LV global strains were evaluated using multiple linear regression, restricted cubic spline (RCS), and subgroup analyses. RESULTS: After full adjustment, the LV global strains from three directions in the high Hb groups (LVGRS: β = - 4.943, 95% CI - 7.673 to - 2.213; LVGCS: β = - 2.341, 95% CI - 3.608 to - 1.074; LVGLS: β = -2.797, 95% CI - 4.049 to - 1.546, all p < 0.05) were significantly reduced than those in their respective moderate-normal Hb groups. Full adjusted RCS plots revealed inverted L-shaped associations between Hb levels and LV global strains, with significant reductions observed above 143 g/L (all p for nonlinearity < 0.05). Subgroup analyses indicated that the associations were more pronounced in MetS patients with obesity (LVGRS: β = - 0.005 [95% CI - 0.087 to 0.097] versus -0.087 [95% CI - 0.145 to - 0.030]; LVGCS: β = -0.006 [95% CI - 0.045 to 0.034] versus -0.048 [95% CI - 0.075 to - 0.021]; LVGLS: β = -0.011 [95% CI - 0.053 to 0.032] versus -0.063 [95% CI - 0.089 to - 0.036] for non-obese and obese patients; all p for interaction < 0.05). CONCLUSIONS: Higher Hb levels are significantly associated with more severe LV dysfunction in MetS patients, particularly in those with obesity. Targeted monitoring and management of higher Hb levels in MetS patients may help mitigate further deterioration of cardiac function.
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Li et al. (2025) conducted an observational in Metabolic syndrome (n=332). High hemoglobin levels vs. Moderate-normal hemoglobin levels (130-139 g/L in women; 140-149 g/L in men) was evaluated on Left ventricular global longitudinal strain (LVGLS) (β -2.797, 95% CI -4.049 to -1.546, p=<0.05). High hemoglobin levels were significantly associated with impaired left ventricular global longitudinal strain (β -2.797) compared to moderate-normal hemoglobin levels in patients with metabolic syndrome.
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