The Association of Left Ventricular Mass Index with Metabolic Syndrome in Comparison to Hypertensive Patients

Rajesh K Gupta; Rimzim Gupta; Neeraj Makar; Shashank Chaudhary; Himanshu Bhatheja; Prashant Pathak

doi:10.4103/2211-4122.183748

The Association of Left Ventricular Mass Index with Metabolic Syndrome in Comparison to Hypertensive Patients

J Cardiovasc Echogr. 2016 Apr-Jun;26(2):42-47. doi: 10.4103/2211-4122.183748.

Authors

Rajesh K Gupta¹, Rimzim Gupta², Neeraj Makar³, Shashank Chaudhary³, Himanshu Bhatheja³, Prashant Pathak³

Affiliations

¹ Department of Medicine, Institute for Medical Sciences and Research Centre, Jaipur National University, Jaipur, Rajasthan, India.
² Department of Pediatrics, Institute for Medical Sciences and Research Centre, Jaipur National University, Jaipur, Rajasthan, India.
³ Department of Medicine, Mahatma Gandhi Hospital, Jaipur, Rajasthan, India.

Abstract

Background and objectives: The metabolic syndrome (MS) is a condition associated with the clustering of risk factors including high blood pressure (BP), abdominal obesity, glucose intolerance, and dyslipidemia; which increases cardiovascular morbidity and mortality. High burden of subclinical disease component of MS contributes to the increased risk by causing left ventricular (LV) hypertrophy, thereby affecting long-term prognosis. This cross-sectional study uncovers the role of LV hypertrophy (LVH) and LV mass index (LVMI) in patients with MS in comparison to hypertensive patients.

Subjects and methods: A total of fifty North Indians, out of which 25 subjects were cases with the MS (obesity, dyslipidemia, glucose intolerance/diabetes with hypertension) and rest of the 25 subjects were control with hypertensive patients were included in the study and assessed for LVH and LVMI by two-dimensional echocardiography. Data were analyzed by SPSS version 21.0 based program.

Results: MS cases had a significantly higher mean LVMI (49.60 ± 21.23 g/m^2.7) (P < 0.05), also higher exposure rate of LVH with 11 cases (44%) and relative risk of 1.38 (odds ratio 1.67, 95% confidence interval 0.53-5.29) than controls with hypertensive patients. Among LVH patients, mean LVMI was highest in MS cases with males (50.31 ± 26.03 g/m^2.7), high body mass index >30 kg/m² (51.14 ± 22.08 g/m^2.7), FBS ≤ 140 mg/dl (53.72 ± 27.91 g/m^2.7), high TG > 150 mg/dl (50.00 ± 22.09 g/m^2.7), and low HDL (male <40, female <50 mg/dl) (57.22 ± 27.23 g/m^2.7) than controls with hypertension; respectively (P > 0.05, not significant).

Conclusion: MS, as a clustering of cardiovascular risk factors, is associated with higher LVM and prevalence of LVH. Therefore, high BP, increased waist circumference, dyslipidemia, and hyperglycemia separately and additively contributes to LVH suggesting that optimal BP control along with weight loss, lipid lowering agents, and euglycemic state may contribute to regression of LVH and LVM.

Keywords: Hypertension; left ventricular hypertrophy; left ventricular mass; left ventricular mass index; metabolic syndrome.