Alteraciones Cardiacas Producto De Alteraciones Metabolicas

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Mayo Clin Proc. Author manuscript; available in PMC 2009 August 13.
Published in final edited form as: Mayo Clin Proc. 2008 December ; 83(12): 1350–1357.

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Abnormal Cardiac Structure and Function in the Metabolic Syndrome: A Population-Based Study
Bilal Aijaz, MD, Khawaja A. Ammar, MD,Francisco Lopez-Jimenez, MD, Margaret M. Redfield, MD, Steven J. Jacobsen, MD, PHD, and Richard J. Rodeheffer, MD From the Department of Internal Medicine (B.A.) and Division of Cardiovascular Diseases (K.A.A., F.L.-J., M.M.R., R.J.R.), Mayo Clinic, Rochester, MN; and Research and Evaluation, Kaiser Permanente Southern California, Pasadena (S.J.J.).

Abstract
OBJECTIVE—To measure the associationbetween cardiac structure and function abnormalities and isolated metabolic syndrome (metabolic syndrome excluding established hypertension or diabetes mellitus). PARTICIPANTS AND METHODS—We collected data prospectively on a population-based random sample of 2042 Olmsted County, Minnesota, residents aged 45 years or older who underwent echocardiography between January 1, 1997, and September 30,2000. Metabolic syndrome was defined by National Cholesterol Education Program Adult Treatment Panel III criteria. RESULTS—The prevalence of isolated metabolic syndrome was 21.7% (214/984) in men and 16.7% (177/1058) in women. Left ventricular (LV) mass index was greater (91.7 vs 87.9 g/m2; P=. 04) and LV diastolic dysfunction more prevalent (28.2% [50/177] vs 14.9% [81/544]; P<.001) in women withisolated metabolic syndrome than in women without metabolic syndrome; no difference was found in men. When patients with hypertension or diabetes mellitus were included in the cohort, there was a stepwise increase in LV mass index and LV diastolic dysfunction from no metabolic syndrome to isolated metabolic syndrome to metabolic syndrome in women and men. CONCLUSION—Isolated metabolic syndrome, whichis associated with increased LV mass index and LV diastolic dysfunction in women, identifies women with evidence of early ventricular dysfunction. Metabolic syndrome is associated with increased risk of cardiovascular disease (CVD) and mortality.1–6 The metabolic syndrome components of diabetes mellitus and hypertension are well known to be associated with abnormal cardiac structure and function,and reversal of these abnormalities is a goal of CVD prevention.7–13 However, whether isolated metabolic syndrome (patients fulfilling the hyperglycemia or elevated blood pressure criteria for metabolic syndrome but not the criteria for diabetes mellitus or hypertension) is also associated with abnormal cardiac structure and function is unknown. If isolated metabolic syndrome identifies personswho have already developed abnormal left ventricular (LV) structure and function, the importance of early recognition of isolated metabolic syndrome would be enhanced. Population-based studies of cardiac structure and function abnormalities in metabolic syndrome are limited, and no studies have included quantitative assessment of LV diastolic

© 2008 Mayo Foundation for Medical Education andResearch Individual reprints of this article are not available. Address correspondence to Richard J. Rodeheffer, MD, Division of Cardiovascular Diseases, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (rodeheffer.richard@mayo.edu).

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function. Few data are available on persons with isolated metabolic syndrome.14 Little is known about the association of sex and LV structure andfunction abnormalities in metabolic syndrome.6,15,16 Hence, the study goals were as follows: (1) to estimate the prevalence of cardiac structure and function abnormalities in a randomly selected cohort of communitydwelling adults with no metabolic syndrome, isolated metabolic syndrome, and metabolic syndrome including hypertension and diabetes and (2) to evaluate the effect of sex on cardiac...