Key result
Lower carotid circumferential strain (≤2.9%) and strain rate (≤0.35 s-1) independently predicted an increased 3-year risk of major cardiovascular events in patients with metabolic syndrome.
Why the study?
The study investigated whether carotid strain and strain rate can predict major cardiovascular events in patients with metabolic syndrome over a 3-year period.
Do carotid artery circumferential strain and strain rate predict major cardiovascular events in adult patients with metabolic syndrome?
Observational (n=220)
No
Do carotid artery circumferential strain and strain rate predict major cardiovascular events in adult patients with metabolic syndrome?
Reduced common carotid artery circumferential strain and strain rate assessed by speckle-tracking ultrasound are independent predictors of major cardiovascular events in patients with metabolic syndrome.
Hypothesis-generating for carotid strain in metabolic syndrome; prospective validation needed before clinical adoption.
Purpose: The goal of this study is to see if carotid strain and strain rate can predict major cardio-vascular events (MACE) in people who have metabolic syndrome (MS) over a 3-year period of time. Methods: In this prospective observational research, we enrolled 220 adult MS patients (60.7 ± 7.5 years old, 53% male). Two-dimensional common carotid carotid artery (CCA) speckle-tracking ultrasound was used to determine the peak circumferential strain (CS) and the peak circumferential strain rate (CSR). Clinical outcomes were assessed throughout a three-year follow-up period. Results: After a 3-year follow-up period follow-up, 14 (7%) experienced MACE: Eight (4%) suffered an atherothrombotic ischemic stroke, four (2%) had acute coronary syndrome, and two (1%) were hospitalized for heart failure. Univariate regression analysis of the clinical and echocardiographic features of the MS patients found that age, systemic hypertension, diabetes mellitus, and the CCA circumferential strain and strain rate were significantly associated with the risk of MACE. Multivariate logistic regression identified two independent predictors of MACE in patients with MS, namely the CCA-related CS (%) and CSR (1/s), p < 0.01. The Receiver operating characteristic (ROC) curve analyses of these independent predictors of MACE indicated appropriate sensitivities and specificities. CS (AUC = 0.806, sensitivity = 82.6%, specificity = 79.2%, p < 0.0001) and CSR (AUC = 0.779, sensitivity = 82.6%, specificity = 72.4%, p < 0.0001) with cut-off values of ≤2.9% for carotid CS and ≤0.35 s-1 for carotid CSR. Using these cut-off values, we obtained Kaplan-Meier survival curves, and these showed that MACE, ischemic stroke, and ACS-free survival was significantly lower among the MS patients with lower carotid CS and CSR (p < 0.0001). Conclusions: Carotid CS and CSR were independent predictors of major cardio- and cerebro-vascular events in prospectively monitored MS patients without established cardiovascular disease. Carotid deformation could be valuable as an early prognostic indicator for the cardiovascular risk in this population group.
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Arnăutu et al. (2022) conducted an observational in Metabolic Syndrome (n=220). Carotid artery circumferential strain (CS) and strain rate (CSR) vs. Normal/higher strain parameters was evaluated on Major cardiovascular events (MACE) (OR 1.04, 95% CI 0.01-0.32, p=<0.01). Lower carotid circumferential strain (≤2.9%) and strain rate (≤0.35 s-1) independently predicted an increased 3-year risk of major cardiovascular events in patients with metabolic syndrome.
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