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Regional myocardial function abnormalities are associated with macro- and microcirculation dysfunction in the metabolic syndrome: the RESOLVE study

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Abstract

Abnormalities in myocardial and vascular function have been reported in the metabolic syndrome (MetS), but whether these alterations are related remains poorly documented. Our aim was accordingly to investigate interrelationships between macro- and microcirculatory vasoreactivity and left ventricular (LV) myocardial function in MetS patients. Eighty-eight MetS individuals and 44 age- and gender-matched healthy controls were enrolled. LV global longitudinal strain (GLS) was measured using Vector Velocity Imaging. Endothelial-dependent and independent reactivity in macro- and microcirculatory territories was established using flow-mediated dilation and nitrate-mediated dilation of the brachial artery and cutaneous blood flow measured with laser Doppler flowmetry in response to iontophoresis of acetylcholine and sodium nitroprusside, respectively. Carotid intima-media thickness (cIMT) was measured according to the Mannheim consensus. Compared to controls, MetS patients presented with reduced GLS (p < 0.001) increased cIMT and impaired (p < 0.001) endothelial and smooth muscle function of the brachial artery and the forearm skin microcirculation. Highly significant relationships (p < 0.01) were noticed between GLS and vascular outcomes. In addition, cIMT (β = 0.21, p = 0.024) and microcirculatory endothelium-dependent reactivity (β = − 0.20, p = 0.035) were identified as independent predictors of GLS. In MetS, abnormalities in myocardial function and endothelial as well as smooth muscle function of small and large arteries co-exist and are closely associated. This study supports a role for microvascular dysfunction in the pathogenesis of LV myocardial dysfunction.

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Funding

The study was supported in part by a grant from the “Fondation Coeur et Artères”.

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Authors and Affiliations

  1. LAPEC EA4278, Faculty of Sciences, University of Avignon, 301 rue Baruch de Spinoza, 84916, Avignon Cedex 9, France

    Philippe Obert, Guillaume Walther & Agnes Vinet

  2. School of Exercise Science, Australian Catholic University, Melbourne, Australia

    Philippe Obert, Frédéric Dutheil & Daniel Courteix

  3. Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological Conditions (AME2P), EA3533, Blaise Pascal University, Clermont-Ferrand, France

    Frédéric Dutheil, Bruno Lesourd & Daniel Courteix

  4. University Hospital of Clermont-Ferrand CHU, Clermont-Ferrand, France

    Frédéric Dutheil & Bruno Lesourd

  5. Omental-Thermalia Center, Châtelguyon, France

    Robert Chapier

Authors
  1. Philippe Obert
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  2. Guillaume Walther
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  3. Frédéric Dutheil
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  4. Bruno Lesourd
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  5. Robert Chapier
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  6. Daniel Courteix
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  7. Agnes Vinet
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Contributions

All authors have read and approved the manuscript. PO is the guarantor of the entire manuscript. PO contributed to acquisition and analysis (cardiac exams), interpretation of data, drafting of the manuscript and critical revision of the manuscript for important intellectual content, and takes responsibility for the integrity of the work as a whole. AV and GW contributed to acquisition and analysis (vascular exams), interpretation of data, and critical revision of the manuscript for important intellectual content. FD contributed to study concept and design, and acquisition of biological data. BL and DC contributed to study concept and design and reviewed the manuscript. RC contributed to study concept and design and interpretation of data.

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Correspondence to Philippe Obert.

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All authors have neither conflict of interest nor financial relationships with industry to disclose.

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Obert, P., Walther, G., Dutheil, F. et al. Regional myocardial function abnormalities are associated with macro- and microcirculation dysfunction in the metabolic syndrome: the RESOLVE study. Heart Vessels 33, 688–694 (2018). https://doi.org/10.1007/s00380-017-1108-y

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  • DOI: https://doi.org/10.1007/s00380-017-1108-y

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