Subclinical left ventricular systolic dysfunction in patients with metabolic syndrome: A case-control study using two-dimensional speckle tracking echocardiography

BACKGROUND The dramatic increase in the prevalence of metabolic syndrome is associated with more increased cardiovascular morbidity and mortality in this group. Some recent studies suggested that metabolic syndrome is associated with increased risk of subclinical left ventricular (LV) systolic dysfunction. In the present cross-sectional case-control study, the utility of two-dimensional speckle tracking echocardiography (STE) was examined to detect early LV systolic dysfunction in this population. METHODS A total of 75 clinically asymptomatic subjects with left ventricular ejection fraction (LVEF) ≥ 55%, 39 without metabolic syndrome and 36 with metabolic syndrome, matched for gender and age, were enrolled in this case-control study. Metabolic syndrome was diagnosed using the National Cholesterol Education Program/Adult Treatment Panel III criteria. LV systolic function was assessed by STE-derived global and segmental longitudinal strain (εLL). RESULTS Global εLL was significantly lower in patients with metabolic syndrome compared with normal population (-18.41 ± 2.20% vs. -21.2 ± 2.1%, P < 0.001). Segmental εLL was significantly lower in patients with metabolic syndrome in comparison to control group except for basal anteroseptal (-19.95 ± 2.90% vs. -21.15 ± 3.30%, P = 0.106), basal anterolateral (-17.5 ± 5.0% vs. -18.3 ± 4.1%, P = 0.437), and basal inferolateral segments (-18.1 ± 6.3% vs. -18.9 ± 4.1%, P = 0.526). CONCLUSION STE-derived longitudinal LV strain (εLL), a marker of subclinical cardiovascular disease, is impaired in asymptomatic individuals with metabolic syndrome and normal LVEF.