Turk Kardiyol Dern Ars. 2010; 38(1): 14-19

Aortic strain and distensibility in patients with metabolic syndrome

Yeşim Güray, Meltem Refiker, Burcu Demirkan, Ümit Güray, Ayça Boyacı, Şule Korkmaz
Türkiye Yüksek Ihtisas Hospital, Department of Cardiology, Ankara, Turkey

OBJECTIVES
Metabolic syndrome (MetS) is associated with increased risk for cardiovascular disease. We evaluated aortic stiffness and factors affecting aortic stiffness by echocardiography in patients with MetS.

STUDY DESIGN
The study included 27 patients (18 men, 9 women; mean age 56±7.5 years) and 33 patients (20 men, 13 women; mean age 54.3±5.5 years) with and without MetS, respectively, according to the ATP-III criteria. Blood pressure, pulse pressure, waist circumference, and levels of total cholesterol, HDL and LDL cholesterol, triglyceride, and high-sensitivity C-reactive protein (hs-CRP) were measured. Systolic and diastolic diameters of the ascending aorta were measured by M-mode echocardiography from the parasternal long-axis views, and parameters of aortic stiffness (aortic strain and distensibility) were calculated.

RESULTS
Compared to the control group, patients with MetS had significantly higher values of blood pressure, pulse pressure, waist circumference, and higher triglyceride, glucose, and hs-CRP levels and lower HDL cholesterol level (p<0.05). In the MetS group, aortic strain (9.0±3.5% vs. 6.3±3.8%; p=0.007) was significantly increased and aortic distensibility (2.7±1.9 cm2/dyn/103 vs. 4.8±1.9 cm2/dyn/103; p=0.001) was significantly decreased. Aortic distensibility was negatively correlated with age (r=-0.269, p=0.03), hs-CRP (r=-0.287, p=0.002), systolic blood pressure (r=-0.533, p<0.001), and diastolic blood pressure (r=-0.275, p=0.03). In age-adjusted multiple regression analysis, systolic blood pressure (β=0.8, p<0.001), waist circumference (β=0.5, p=0.02), and hs-CRP (β=0.6, p=0.002) were independent predictors of aortic distensibility.

CONCLUSION
Aortic stiffness is increased in patients with MetS. Using a noninvasive and readily available tool, transthoracic echocardiography, arterial stiffness can easily be assessed, so that the incidence of cardiovascular diseases and associated mortality can be decreased through appropriate treatment for risk factors.

Keywords: Cardiovascular diseases, C-reactive protein, echocardiography, elasticity; metabolic syndrome X/complications; risk factors; vascular resistance

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