cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLC10.15829/1728-8800-2016-2-63-68cardiovascular-389Research ArticleМЕТАБОЛИЧЕСКИЙ СИНДРОМMETABOLIC SYNDROMEЭхокардиографическая оценка сердца у больных с метаболическим синдромом, осложненным нарушениями сердечного ритмаEchocardiographic assessment of the heart in metabolic syndrome complicated with hearth rhythm disordersДжишамбаевЭ. Д.DzhishambaevE. D.

отделение нарушений ритма сердца

д.м.н., заведующий

АманалиеваН. О.AmanalievaN. O.

отделение нарушений ритма сердца

н.с. 

Тел.: +996-556-004-278 

ino_888@mail.ruУсупбаеваД. А.UsulbaevaD. A.

отделение функциональной диагностики

д.м.н., заведующая 

СулаймановаС. К.SulaymanovaS. K.

отделение нарушений ритма сердца

м.н.с. 

Национальный центр кардиологии и терапии имени М.М. Миррахимова. БишкекM.M. Mirrakhimov National Center of Cardiology. Bishkek2016200420161526368Copyright © Джишамбаев Э.Д., Аманалиева Н.О., Усупбаева Д.А., Сулайманова С.К., 20162016Джишамбаев Э.Д., Аманалиева Н.О., Усупбаева Д.А., Сулайманова С.К.Dzhishambaev E.D., Amanalieva N.O., Usulbaeva D.A., Sulaymanova S.K.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/389Цель

Цель. Изучение параметров насосной функции и геометрии левого желудочка (ЛЖ) у пациентов с метаболическим синдромом (МС) в зависимости от аритмий сердца (АС).

Материал и методы

Материал и методы. Обследованы 208 мужчин с МС в возрасте 35-55 лет. Всем больным проводилась регистрация стандартной электрокардиограммы, велоэргометрическая проба, суточное мониторирование электрокардиограммы, одно- и двумерная эхокардиография.

Результаты

Результаты. У больных с МС с сочетанными АС выявлена небольшая асимметрия ЛЖ, вследствие достоверного увеличения толщины межжелудочковой перегородки. У больных с желудочковой экстрасистолией — одинаковая степень утолщения как межжелудочковой перегородки, так и задней стенки ЛЖ, сопровождающаяся развитием пограничной массы миокарда ЛЖ. Выявлено также, что при асимметрическом ремоделировании развиваются преимущественно наджелудочковые АС, а при явной гипертрофии ЛЖ — как над-, так и желудочковые АС.

Заключение

Заключение. Ремоделирование ЛЖ и развитие пограничной массы миокарда может быть одной из причин возникновения нарушений сердечного ритма у больных с МС. 

Aim

Aim. To study parameters of heart pumping function and left ventricle (LV) geometry in metabolic syndrome patients (MS) depending on the heart rhythm disorders (RD)

Material and methods

Material and methods. Totally, 208 men with MS studied, age 35-55 y.o. All patients underwent registration of standard electrocardiogram, veloergometry, ambulatory electrocardiogram monitoring, single- or bidimensional echocardiograpy.

Results

Results. In MS patients with combinational RD there was slight asymmetry of the LV, due to significant increase of interventricular septum thickness. In patients with ventricular extrasystoly — same grade of interventricular septum thickening, as of back wall of LV, with the appearance of borderline myocardial mass of LV. In addition, it was found, that in asymmetric remodelling there are mostly supraventricular RD develop, and in significant hypertrophy of LV — supra- and ventricular RD.

Conclusion

Conclusion. LV remodelling and development of borderline myocardial mass is one of the causes for cardiac rhythm disorders in MS patients. 

метаболический синдромгеометрия сердцааритмии сердцагипертрофия левого желудочкаартериальная гипертониясахарный диабетmetabolic syndromeheart geometryheart arrhythmiasleft ventricle geometryarterial hypertensiondiabetes mellitusReferencesThomas GN, Schooling CM, McGhee SM, et al. Metabolic syndrome increased allcause and vascular mortality: the Hong Kong Cardiovascular Risk Factor Study. Clin Endocrinol (Oxf) 2007; 66(5): 666-71.Thomas GN, Schooling CM, McGhee SM, et al. Metabolic syndrome increased allcause and vascular mortality: the Hong Kong Cardiovascular Risk Factor Study. Clin Endocrinol (Oxf) 2007; 66(5): 666-71.Empana JP, Duciemetiere P, Balkau B, Jouven X. Contribution of the metabolic syndrome to sudden death risk in asymptomatic men: the Paris Prospective Study I. Eur Heart J 2007; 28: 1149-54.Empana JP, Duciemetiere P, Balkau B, Jouven X. Contribution of the metabolic syndrome to sudden death risk in asymptomatic men: the Paris Prospective Study I. Eur Heart J 2007; 28: 1149-54.Provotorov VM, Gluhovskii ML. Cardiac arrhythmias and conduction disturbance in patients with early stage of metabolic syndrome. Klin Med (Mosk) 2009; 7: 26-2. Russian (Провоторов В.М., Глуховский М.Л. Расстройства ритма и проводимости у пациентов с начальными стадиями метаболического синдрома. Клиническая медицина 2009; 7: 26-8).Provotorov VM, Gluhovskii ML. Cardiac arrhythmias and conduction disturbance in patients with early stage of metabolic syndrome. Klin Med (Mosk) 2009; 7: 26-2. Russian (Провоторов В.М., Глуховский М.Л. Расстройства ритма и проводимости у пациентов с начальными стадиями метаболического синдрома. Клиническая медицина 2009; 7: 26-8).Onuchina EL, Solov’ev OV, Onuchin SG, et al. Assessment of risk factors for atrial fibrillation in patients with the metabolic syndrome. Klin Med (Mosk) 2012; 90(1): 72-6. Russian (Онучина Е.Л., Соловьев О.В., Онучин С.Г. и др. Оценка факторов риска развития фибрилляции предсердий у пациентов с метаболическим синдромом. Клиническая медицина 2012; 90(1): 72-6).Onuchina EL, Solov’ev OV, Onuchin SG, et al. Assessment of risk factors for atrial fibrillation in patients with the metabolic syndrome. Klin Med (Mosk) 2012; 90(1): 72-6. Russian (Онучина Е.Л., Соловьев О.В., Онучин С.Г. и др. Оценка факторов риска развития фибрилляции предсердий у пациентов с метаболическим синдромом. Клиническая медицина 2012; 90(1): 72-6).Sorrentino F, Busa A, Averna M, Nigro P. Ventricular arrhythmias in hypertensive patients with mild metabolic alterations. Minerva Cardioangiol. 2003; 51(1): 68-70.Sorrentino F, Busa A, Averna M, Nigro P. Ventricular arrhythmias in hypertensive patients with mild metabolic alterations. Minerva Cardioangiol. 2003; 51(1): 68-70.Watanabe H, Tanabe N, Watanabe T, et al. Metabolic syndrome and risk of development of atrial fibrillation: the Niigata preventive medicine study. Circulation 2008;117(10):1255-60.Watanabe H, Tanabe N, Watanabe T, et al. Metabolic syndrome and risk of development of atrial fibrillation: the Niigata preventive medicine study. Circulation 2008;117(10):1255-60.Mulè G, Nardi E, Cottone S, et al. Impact of metabolic syndrome on left ventricular mass in overweight and obese hypertensive subjects. Inter J Cardiol 2007; 121(3): 267-75.Mulè G, Nardi E, Cottone S, et al. Impact of metabolic syndrome on left ventricular mass in overweight and obese hypertensive subjects. Inter J Cardiol 2007; 121(3): 267-75.Schillaci G, Pirro M, Pucci G, et al. Different impact of the metabolic syndrome on left ventricular structure and function in hypertensive man and women. Hypertension 2006; 47: 881-6.Schillaci G, Pirro M, Pucci G, et al. Different impact of the metabolic syndrome on left ventricular structure and function in hypertensive man and women. Hypertension 2006; 47: 881-6.Palmieri V, Bella JN, Arnett DK, et al. Effect of type 2 diabetes mellitus on left ventricular geometry and systolic function in hypertensive subjects: Hypertension Genetic Epidemiology Network (HyperGEN) study. Circulation 2001; 103(1): 102-7.Palmieri V, Bella JN, Arnett DK, et al. Effect of type 2 diabetes mellitus on left ventricular geometry and systolic function in hypertensive subjects: Hypertension Genetic Epidemiology Network (HyperGEN) study. Circulation 2001; 103(1): 102-7.Schillaci G, Vaudo G, Reboldi G, et al. High-density lipoprotein cholesterol and left ventricular hypertrophy in essential hypertension. J Hypertens. 2001; 19(12): 2265-70.Schillaci G, Vaudo G, Reboldi G, et al. High-density lipoprotein cholesterol and left ventricular hypertrophy in essential hypertension. J Hypertens. 2001; 19(12): 2265-70.Lazutin VK, Nychkina TN, Litvinceva VP, et al. The clinical significance of cardiac arrhythmias in patients with essential hypertension. Kardiologiia 1991; 4: 71-4. Russian (Лазутин В.К, Нычкина Т.Н, Литвинцева В.П. и др. Клиническое значение нарушений сердечного ритма у больных гипертонической болезнью. Кардиология 1991; 4: 71-4).Lazutin VK, Nychkina TN, Litvinceva VP, et al. The clinical significance of cardiac arrhythmias in patients with essential hypertension. Kardiologiia 1991; 4: 71-4. Russian (Лазутин В.К, Нычкина Т.Н, Литвинцева В.П. и др. Клиническое значение нарушений сердечного ритма у больных гипертонической болезнью. Кардиология 1991; 4: 71-4).Messerli FH, Ventura HO, Elizardi DJ, et al. Hypertension and sudden death: increased ventricular ectopic activity in left ventricular hypertrophy. Am J Med 1984; 77: 18-21.Messerli FH, Ventura HO, Elizardi DJ, et al. Hypertension and sudden death: increased ventricular ectopic activity in left ventricular hypertrophy. Am J Med 1984; 77: 18-21.Levy D, Anderson K.M, Savage DD, et al. Risk of ventricular arrhythmias in left ventricular hypertrophy: the Framingham Heart Study. Am J Cardiol 1987; 60: 560-5.Levy D, Anderson K.M, Savage DD, et al. Risk of ventricular arrhythmias in left ventricular hypertrophy: the Framingham Heart Study. Am J Cardiol 1987; 60: 560-5.Grandi AM, Maresca AM, Glucidi E, et al. Metabolic syndrome and morphofunctional characteristics of the left ventricle in clinically hypertensive nondiabetic subjects. Am J Hypertens 2006; 19: 199-200.Grandi AM, Maresca AM, Glucidi E, et al. Metabolic syndrome and morphofunctional characteristics of the left ventricle in clinically hypertensive nondiabetic subjects. Am J Hypertens 2006; 19: 199-200.Woodiwiss AJ, Libhaber CD, Majane OH, et al. Obesity promotes left ventricular concentric rather than eccentric geometric remodeling and hypertrophy independent of blood pressure. Am J Hypertens 2008; 21(10): 1144-51.Woodiwiss AJ, Libhaber CD, Majane OH, et al. Obesity promotes left ventricular concentric rather than eccentric geometric remodeling and hypertrophy independent of blood pressure. Am J Hypertens 2008; 21(10): 1144-51.Mahmud A, Almuntaser I, Brown E, et al. Left ventricular structural and functional changes in the metabolic syndrome. J Cardiometab Syndr 2009; 4: 81-8.Mahmud A, Almuntaser I, Brown E, et al. Left ventricular structural and functional changes in the metabolic syndrome. J Cardiometab Syndr 2009; 4: 81-8.Nunez BD, Lavie CJ, Messerli FH, et al. Comparison of diastolic left ventricular filling and cardiac arrhythmias in hypertensive patients with and without isolated septal hypertrophy. Am J Cardiol 1994; 76: 585-9.Nunez BD, Lavie CJ, Messerli FH, et al. Comparison of diastolic left ventricular filling and cardiac arrhythmias in hypertensive patients with and without isolated septal hypertrophy. Am J Cardiol 1994; 76: 585-9.Chinali M, de Simone G, Roman MJ, et al. Impact of obesity on cardiac geometry and function in a population of adolescents: the Strong Heart Study. JACC 2006; 47(11): 2267-73.Chinali M, de Simone G, Roman MJ, et al. Impact of obesity on cardiac geometry and function in a population of adolescents: the Strong Heart Study. JACC 2006; 47(11): 2267-73.Mulè G, Nardi E, Cottone S, et al. Impact of metabolic syndrome on left ventricular mass in overweight and obese hypertensive subjects. Int J Cardiol 2007; 121(3): 267-75.Mulè G, Nardi E, Cottone S, et al. Impact of metabolic syndrome on left ventricular mass in overweight and obese hypertensive subjects. Int J Cardiol 2007; 121(3): 267-75.Krumholz HM, Larson M, Levy D. Prognosis of left ventricular geometric patterns in the Framingham Heart Study. JACC 1995; 25(4): 879-84.Krumholz HM, Larson M, Levy D. Prognosis of left ventricular geometric patterns in the Framingham Heart Study. JACC 1995; 25(4): 879-84.Verdecchia P, Schillaci G, Borgioni C, et al. Adverse prognostic significance of concentric remodeling of the left ventricle in hypertensive subjects with normal left ventricular mass. JACC 1995; 25: 871-8.Verdecchia P, Schillaci G, Borgioni C, et al. Adverse prognostic significance of concentric remodeling of the left ventricle in hypertensive subjects with normal left ventricular mass. JACC 1995; 25: 871-8.Eguchi K, Ishikawa J, Hoshide S, et al. Differential impact of left ventricular mass and relative wall thickness on cardiovascular prognosis in diabetic and nondiabetic hypertensive subjects. Am Heart J 2007; 154(1): 9-15.Eguchi K, Ishikawa J, Hoshide S, et al. Differential impact of left ventricular mass and relative wall thickness on cardiovascular prognosis in diabetic and nondiabetic hypertensive subjects. Am Heart J 2007; 154(1): 9-15.Lavie CJ, Milani RV, Patel D, et al. Disparate effects of obesity and left ventricular geometry on mortality in 8088 elderly patients with preserved systolic function. Postgrad Med 2009; 121(3): 119-25.Lavie CJ, Milani RV, Patel D, et al. Disparate effects of obesity and left ventricular geometry on mortality in 8088 elderly patients with preserved systolic function. Postgrad Med 2009; 121(3): 119-25.Levy D, Anderson KM, Savage DD, et al. Risk of ventricular arrhythmias in left ventricular hypertrophy: the Framingham Heart Study. Am J Cardiol 1987; 60(7): 560-5.Levy D, Anderson KM, Savage DD, et al. Risk of ventricular arrhythmias in left ventricular hypertrophy: the Framingham Heart Study. Am J Cardiol 1987; 60(7): 560-5.Bayés-Genís A, Guindo J, Viñolas X, et al. Cardiac arrhythmias and left ventricular hypertrophy in systemic hypertension and their influences on prognosis. Am J Cardiol 1995; 76(13): 54D-9.Bayés-Genís A, Guindo J, Viñolas X, et al. Cardiac arrhythmias and left ventricular hypertrophy in systemic hypertension and their influences on prognosis. Am J Cardiol 1995; 76(13): 54D-9.

The authors declare that there are no conflicts of interest present.