Key result
Metabolic syndrome and higher insulin resistance were associated with impaired diastolic function, independent of myocardial extracellular volume.
Why the study?
Is metabolic syndrome associated with impaired diastolic function and myocardial extracellular matrix changes independent of extracellular volume?
Cross-Sectional (n=1,582)
Yes
Is metabolic syndrome associated with impaired diastolic function and myocardial extracellular matrix changes independent of extracellular volume?
Metabolic syndrome is independently associated with impaired diastolic function, likely due to intrinsic cardiomyocyte alterations rather than myocardial fibrosis.
Answers are grounded in this paper and cite their sources.
May inform diastolic dysfunction evaluation in metabolic syndrome; hypothesis-generating for insulin resistance as a modifiable target.
The relationship of metabolic syndrome (MetS) and insulin resistance (one of its key pathophysiological mediators) with diastolic dysfunction and myocardial fibrosis is not well understood. This study aimed to evaluate the association of MetS with diastolic function and myocardial extracellular matrix (ECM) using cardiac MRI (CMRI) in a large community-based population. This cross-sectional analysis included 1,582 participants from the Multi-Ethnic Study of Atherosclerosis (MESA) with left ventricular ejection fraction ≥50% and no history of cardiac events. Diastolic function was assessed using tagged CMRI parameters including end-diastolic strain rate (EDSR) and strain relaxation index (SRI). ECM was evaluated using extracellular volume (ECV) quantification. Participants' mean age was 67.4 ± 8.6 years, and 48.1% were males. MetS was present in 533 individuals (33.7%), and type 2 diabetes in 250 (15.8%). In the multivariable analyses, MetS (irrespective of the presence of type 2 diabetes) and higher insulin resistance were associated with impaired diastolic function (higher SRI and lower EDSR), independent of ECV. In conclusion, MetS, irrespective of the presence of type 2 diabetes, was independently associated with impaired diastole. These functional myocardial changes seem to result from intrinsic cardiomyocyte alterations, irrespective of the myocardial interstitium (including fibrosis).
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Ladeiras‐Lopes et al. (2018) conducted a cross-sectional in Metabolic syndrome (n=1,582). Metabolic syndrome vs. Absence of metabolic syndrome was evaluated on Diastolic function (end-diastolic strain rate and strain relaxation index). Metabolic syndrome and higher insulin resistance were associated with impaired diastolic function, independent of myocardial extracellular volume.
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