What Is the Effect of Metabolic Syndrome without Hypertension on Left Ventricular Hypertrophy?

BACKGROUND: Left ventricular hypertrophy (LVH) is an independent risk factor for cardiovascular events. There is a strong association between metabolic syndrome (MetS) and LVH in hypertensive patients. However, the relation between LVH and MetS in the absence of hypertension has not been studied. AIM OF THE WORK: To study the impact of MetS on LV mass in patients without hypertension. SUBJECTS AND METHODS: Fifty MetS patients without hypertension and 50 healthy control subjects were enrolled. Twelve-lead electrocardiography, laboratory testing, and echocardiography were done with assessment of the left ventricular diastolic (LVEDD) and systolic dimensions (LVESD), fraction of shortening (FS), ejection fraction (EF), Doppler-derived mitral valve flow velocity waves (E-wave, A-wave, E/A ratio), left ventricular mass and mass index (LVMI). RESULTS: There was no significant difference between the two groups regarding LVEDD, LVESD, FS, EF, E-wave velocity, A-wave velocity, or E/A ratio. However, mean posterior wall thickness, IVST, LV mass, LVMI, and incidence of LVH were significantly higher in MetS patients. There was a significant positive correlation between LVMI and blood glucose level (r = 0.528, P < 0.00001), hemoglobin A1c (HbA1c) (r = 0.416, P < 0.0001), triglycerides level (r = 0.535, P < 0.00001), and obesity (r = 0.307, p = 0.0019). There was a significant negative correlation between LVMI and HDL-C level (r = -0.377, P < 0.0001). The same parameters were predictors for LVH in a logistic regression analysis. CONCLUSION: Even in the absence of hypertension, MetS patients had significantly higher LV wall thickness, LV mass and LVMI, and incidence of LVH than control subjects.