The additional impact of metabolic syndrome on left ventricular deformation and myocardial energetic efficiency impairment in ischemia with nonobstructive coronary arteries patients
Authors' conclusion
MetS aggravated LV deformation and function impairment in patients with INOCA. MetS was found to be an independent factor of impaired MEEI and LV GLPS, the further decrease of MEEI and LV GLPS in INOCA patients caused by MetS might involve the synergistic injury mechanism. Early diagnosis and treatment of MetS in patients with INOCA are important.
Study context
- Population
- Patients with ischemia with nonobstructive coronary arteries (INOCA), with or without metabolic syndrome (MetS), and matched controls104 INOCA patients
- Participants
- 48 / 56 / 41
- Exposure
- INOCA with MetS vs INOCA without MetS vs controls
- INOCA (MetS+)n = 48
- INOCA (MetS-)n = 56reference
- Controlsn = 41
- Outcome
- LV function, indexed myocardial energetic efficiency (MEEI) and LV global peak strains (radial, circumferential, longitudinal)
Methodological detailssex- and age-matched controls, multivariable linear regression
- Sex- and age-matched controls
- Multivariable linear regression
Main finding
As reported in the abstract
LV stroke volume index (LVSVI), MEEI and LV global longitudinal peak strain (GLPS)
| Group | Value | Myocardial energetic efficiency (MEEI) median (range) | Left ventricular (LV) global longitudinal peak strain (GLPS) | MEEI |
|---|---|---|---|---|
| INOCA (MetS-) | mean 49.57 ± 11.58 mL/m² | 0.85(0.70-1.03) ml/s/g | - 13.26 ± 2.86% | |
| INOCA (MetS+) | mean 42.58 ± 12.23 mL/m² | −10.95 ± 3.93% | 0.75(0.54-0.91) ml/s/g |
Value
INOCA (MetS-)mean 49.57 ± 11.58 mL/m²
INOCA (MetS+)mean 42.58 ± 12.23 mL/m²
Myocardial energetic efficiency (MEEI) median (range)
INOCA (MetS-)0.85(0.70-1.03) ml/s/g
INOCA (MetS+)— not stated in the abstract
Left ventricular (LV) global longitudinal peak strain (GLPS)
INOCA (MetS-)- 13.26 ± 2.86%
INOCA (MetS+)−10.95 ± 3.93%
MEEI
INOCA (MetS-)— not stated in the abstract
INOCA (MetS+)0.75(0.54-0.91) ml/s/g
- INOCA (MetS+) vs INOCA (MetS-): P = 0.007 — lower with MetS+
- INOCA (MetS+) vs INOCA (MetS-): P = 0.045 — lower with MetS+
- INOCA (MetS+) vs INOCA (MetS-): P = 0.001 — reduced with MetS+
Observational data: associations, not effects.
Further findings
| Outcome | Controls | P value |
|---|---|---|
| LV GLPS, controls vs INOCA (MetS-)GLPS decreased in INOCA (MetS-) | mean - 15.14 ± 2.83 % | P = 0.017 |
- LV GLPS, controls vs INOCA (MetS-): INOCA (MetS-) mean −13.26 ± 2.86 %
Independent association of MetS in INOCA (multivariable)
- MetS and LVSVI, β
- −0.231 (p = 0.012)
- MetS and MEEI, β
- −0.262 (p = 0.009)
- MetS and LV GLPS, β
- −0.266 (p = 0.002)
- After multivariable adjustment
Other independent factors of impaired MEEI
- Calcium channel blockers, β
- 0.320 (p = 0.001)
- Hypertension, β
- −0.298 (p = 0.002)
Original publication
The additional impact of metabolic syndrome on left ventricular deformation and myocardial energetic efficiency impairment in ischemia with nonobstructive coronary arteries patients. Cardiovasc Diabetol. Published 18 January 2025. doi:10.
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