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Does metabolic syndrome worsen systolic dysfunction in diabetes? The shortwave study

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Abstract

Patients with metabolic syndrome (MetS) have high cardiovascular event rates. The additional effect of MetS on left ventricular (LV) systolic function in patients with type 2 diabetes mellitus (T2DM) is unknown. We studied the relation between MetS and LV systolic function in T2DM patients without coronary artery disease (CAD). Clinical and echocardiographic data from 331 T2DM patients were analyzed. Prevalence of MetS was assessed based on NCEP ATPIII definition. Stress-corrected midwall shortening (sc-MS) and mitral annular peak systolic velocity (S’) were analyzed as indexes of circumferential and longitudinal shortening, respectively. Sc-MS was impaired if <89 %, S’ if <8.5 cm/s (10th percentile of healthy controls). MetS was diagnosed in 172 patients. Sc-MS and S’ were similar in T2DM patients with and without MetS (91 ± 14 vs 92 ± 15 %; 9.8 ± 2.0 vs 9.5 ± 2.1 cm/s, respectively; p = ns) but significantly reduced comparing to controls (102 ± 11 % and 10.8 cm/s; p < 0.0001). Impairment of sc-MS and S’ were detected in 37 vs 40 % and in 29 vs 32 % of T2DM patients with and without MetS (p = ns), respectively. LV systolic function measured as sc-MS and S’ is frequently impaired in T2DM patients without CAD; however, the coexistence of MetS is not associated with more severe LV systolic dysfunction. Further pathological mechanisms have to be considered to explain the negative prognostic impact of MetS in T2DM patients.

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Conflict of interest

Giorgio Faganello, Giovanni Cioffi, Pompilio Faggiano, Riccardo Candido, Luigi Tarantini, Stefania De Feo, Andrea Di Lenarda, Giovanni de Simone declare that they have no conflict of interest.

Human and animal rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5).

Informed consent

Informed consent was obtained from all patients for being included in the study.

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Authors and Affiliations

  1. Cardiovascular Center, Azienda per i Servizi Sanitari n° 1, via Slataper n° 9, 34100, Trieste, Italy

    Giorgio Faganello & Andrea Di Lenarda

  2. Department of Cardiology, Villa Bianca Hospital, Trento, Italy

    Giovanni Cioffi

  3. Cardiology Unit, Spedali Civili, Brescia, Italy

    Pompilio Faggiano

  4. Diabetology, Azienda per i Servizi Sanitari n° 1, Trieste, Italy

    Riccardo Candido

  5. Department of Cardiology, Ospedale Civile S. Martino, Belluno, Italy

    Luigi Tarantini

  6. Department of Cardiology, Pederzolli Hospital, Peschiera, Italy

    Stefania De Feo

  7. Department of Translational Medical Sciences, Federico II, University Hospital, School of Medicine, Naples, Italy

    Giovanni de Simone

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  1. Giorgio Faganello
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  2. Giovanni Cioffi
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  3. Pompilio Faggiano
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  5. Luigi Tarantini
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  6. Stefania De Feo
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  7. Andrea Di Lenarda
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  8. Giovanni de Simone
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Correspondence to Giorgio Faganello.

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Faganello, G., Cioffi, G., Faggiano, P. et al. Does metabolic syndrome worsen systolic dysfunction in diabetes? The shortwave study. Acta Diabetol 52, 143–151 (2015). https://doi.org/10.1007/s00592-014-0620-0

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  • DOI: https://doi.org/10.1007/s00592-014-0620-0

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