La obesidad central es el componente clave en la asociación del síndrome metabólico con el deterioro del strain longitudinal global del ventrículo izquierdo
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Wilson Cañon-Montañez [1] ; Angela B.S. Santos [2] ; Lisandra A. Nunes [1] ; Julio C.G. Pires [2] ; Claudia M.V. Freire [3] ; Antonio L.P. Ribeiro [3] ; José G. Mill [4] ; Marina Bessel [1] ; Bruce B. Duncan [1] ; Maria Inês Schmidt [1] ; Murilo Foppa [1]
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[1] Universidade Federal do Rio Grande do Sul
Universidade Federal do Rio Grande do Sul
Brasil
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[2] Hospital de Clínicas de Porto Alegre
Hospital de Clínicas de Porto Alegre
Brasil
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[3] Universidade Federal de Minas Gerais
Universidade Federal de Minas Gerais
Brasil
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[4] Universidade Federal do Espírito Santo
Universidade Federal do Espírito Santo
Brasil
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- Localización: Revista española de cardiología, ISSN 0300-8932, Vol. 71, Nº. 7, 2018, págs. 524-530
- Idioma: español
- Títulos paralelos:
- Central Obesity is the Key Component in the Association of Metabolic Syndrome With Left Ventricular Global Longitudinal Strain Impairment
- Enlaces
- Dialnet Métricas: 2 Citas
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Resumen
- español
Introducción y objetivos La disfunción sistólica subclínica es uno de los mecanismos propuestos para el aumento del riesgo cardiovascular asociado con el síndrome metabólico (SM). Este estudio investigó la asociación entre SM y deterioro del strain longitudinal global (SLG) del ventrículo izquierdo y el papel de cada criterio de SM en esta asociación.
Métodos Se analizó una muestra aleatoria del Estudo Longitudinal da Saúde do Adulto (ELSA-Brasil) después de excluir a aquellos con cardiopatía prevalente.
Resultados De los 1.055 participantes que cumplían los criterios de inclusión (el 53% mujeres; edad, 52 ± 9 años), 444 (42%) reunían criterios de SM. Aquellos con SM presentaron un SLG más reducido (–18,0 ± 2,5%) que aquellos sin SM (–19,0 ± 2,4%; p < 0,0001). En los modelos de regresión lineal múltiple, el SM se asoció con SLG más reducido después de ajustar por varios factores de riesgo (diferencia de SLG, 0,86%; p < 0,0001), incluso después de incluir el índice de masa corporal. Las TP ajustadas para los participantes con SLG reducido evaluados con 3 puntos de corte (1, 1,5 y 2 desviaciones estándar) fueron más altas entre aquellos con SM que sin este: SLG –16,1% (TP = 1,76; IC95%, 1,30-2,39); SLG –14,8% (TP = 2,35; IC95%, 1,45-3,81), y SLG –13,5% (TP = 2,07; IC95%, 0,97-4,41). Después de incluir el índice de masa corporal en los modelos, estas asociaciones se atenuaron; lo que indica que la obesidad puede mediar, al menos en parte, estas asociaciones. En los análisis de regresión cuantílica, la circunferencia de cintura aumentada fue el único componente del SM que se halló independientemente asociado con el SLG a lo largo de todo el rango de valores.
Conclusiones El SM se asocia de manera independiente con alteración del SLG. Entre los criterios de SM, la obesidad central describe mejor la relación entre el trastorno metabólico y la función cardiaca.
- English
Introduction and objectives Subclinical systolic dysfunction is one of the proposed mechanisms for increased cardiovascular risk associated with metabolic syndrome (MS). This study investigated the association between MS and impaired left ventricular global longitudinal strain (GLS) and the role of each MS criteria in this association.
Introduction and objectives Subclinical systolic dysfunction is one of the proposed mechanisms for increased cardiovascular risk associated with metabolic syndrome (MS). This study investigated the association between MS and impaired left ventricular global longitudinal strain (GLS) and the role of each MS criteria in this association.
Methods We analyzed a random sample of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) after excluding participants with prevalent heart disease.
Methods We analyzed a random sample of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) after excluding participants with prevalent heart disease.
Among the 1055 participants fulfilling the inclusion criteria (53% women; 52 ± 9 years), 444 (42%) had MS. Those with MS had worse GLS (–18.0% ± 2.5%) than those without (–19.0% ± 2.4%; P < .0001). In multiple linear regression models, MS was associated with worse GLS after adjustment for various risk factors (GLS difference = 0.86%; P < .0001), even after inclusion of body mass index. Adjusted PR for impaired GLS as assessed by 3 cutoffs (1, 1.5, and 2 standard deviations) were higher among participants with than without MS: GLS –16.1% (PR, 1.76; 95%CI, 1.30-2.39); GLS –14.8% (PR, 2.35; 95%CI, 1.45-3.81); and GLS –13.5% (PR, 2.07; 95%CI, 0.97-4.41). After inclusion of body mass index in the models, these associations were attenuated, suggesting that they may, at least in part, be mediated by obesity. In quantile regression analyses, elevated waist circumference was the only MS component found to be independently associated with GLS across the whole range of values.
Results Among the 1055 participants fulfilling the inclusion criteria (53% women; 52 ± 9 years), 444 (42%) had MS. Those with MS had worse GLS (–18.0% ± 2.5%) than those without (–19.0% ± 2.4%; P < .0001). In multiple linear regression models, MS was associated with worse GLS after adjustment for various risk factors (GLS difference = 0.86%; P < .0001), even after inclusion of body mass index. Adjusted PR for impaired GLS as assessed by 3 cutoffs (1, 1.5, and 2 standard deviations) were higher among participants with than without MS: GLS –16.1% (PR, 1.76; 95%CI, 1.30-2.39); GLS –14.8% (PR, 2.35; 95%CI, 1.45-3.81); and GLS –13.5% (PR, 2.07; 95%CI, 0.97-4.41). After inclusion of body mass index in the models, these associations were attenuated, suggesting that they may, at least in part, be mediated by obesity. In quantile regression analyses, elevated waist circumference was the only MS component found to be independently associated with GLS across the whole range of values.
Conclusions Metabolic syndrome is independently associated with impaired GLS. Among the MS criteria, central obesity best depicted the link between metabolic derangement and cardiac function.
Conclusions Metabolic syndrome is independently associated with impaired GLS. Among the MS criteria, central obesity best depicted the link between metabolic derangement and cardiac function.
- español
