Role of the individual metabolic syndrome components and heart remodelling progression in women

Abstract

Aim. To analyze the dynamics of heart structure, geometry, and function in women, in accordance with present components of metabolic syndrome (MS). Material and methods. In total, 245 women, comparable by age and blood pressure (BP) levels, were examined: with arterial hypertension (AH), but without dyslipidemia (DL) or obesity (O) (control group, CG; n=100); with AH and DL, but without O (Group 1; n=37); with AH, DL, abdominal O (mean waist circumference, WC, 104,84±15,92 cm), but without carbohydrate metabolism disturbances (Group 2; n=93); with AH, DL, abdominal O and impaired glucose tolerance, IGT (Group 3; n=15); with AH, DL, abdominal O and new-onset Type 2 diabetes mellitus (DM-2) (Group 4; n=22). All participants underwent echocardiography, with the assessment of left ventricular (LV) remodelling indices, oral glucose tolerance test, and serum lipid profile assessment. Results. DL did not demonstrate an independent role in heart structural and functional changes. In women with MS and impaired carbohydrate metabolism (IGT or DM), remodelling was a manifestation of disadaptation. In these patients, increased body mass index (BMI) and plasma glucose levels were associated with impaired systolic function (increased systolic myocardial stress, reduced ejection fraction, and earlier development of heart failure). Conclusion. In women with various combinations of MS components, heart structure and function changes are different. Insulin resistance facilitates the progression of systolic myocardial stress and myocardial contractility reduction. Increased levels of BMI, serum glucose and glycated hemoglobin were associated with impaired systolic function and earlier development of heart failure in women with MS.