Relationship Of Carotid Artery Intima/Media Thickness And Ventricular Remodeling With Metabolic Syndrome

Objective:To study the structure and function of the carotid artery and to observe the development and characteristic of remodelling of the left ventricle in the metabolic syndrome(MS);To explore the relationship of carotid artery intima/media thickness and ventricular remodeling in patients with metabolic syndrome.Methods:216 patients were divided into three groups:metabolic syndrome(MS 110 cases),essential hypertension (EH 57 cases),and diabetes millitus(DM 49 cases).MS was diagnosed according to 2005 IDF criteria.Doppler echocardiography was applied to measure the left ventricular end diastolic dimension(LVDd),left ventricular posterior wall thickness(LVPWT)and interventricular septal thickness(IVST).The left ventricular mass(LVM)and left ventricular mass index(LVMI)and relative left ventricular thickness(RLVT)was calculated after Doppler Plasma lipids and ultrasonography for carotidartery were examined.Ultrasonography for carotid resistance index and the intima-media thickness (IMT)of common carotid artery were examined.The occurrence rate of carotid plaque was calculated.Results:1)IVST,LVPWT,RLVT in MS patients was obviously higher than that in DM patients and EH patients(P＜0.01).IVST,LVPWT,RLVT in EH patients was obviously higher than that in DM patients(P＜0.01 or P＜0.05)[RLVT in MS: (0.43±0.08)vs RLVT in DM:(0.39±0.05),P＜0.01;RLVT in MS:(0.43±0.08)vs RLVT in EH.(0.39±0.06),P＜0.01].LVDd,left ventricular mass(LVM),LVMI in MS patients and EH patients was obviously higher than that in DM patients(P＜0.01 or P＜0.05),Levels of LVDd,LVM,LVMI were not different with MS and EH(P＞0.05) [LVMI in MS:(45.63±11.27)g/m^2.7vs LVMI in DM:(32.54±8.75)g/m^2.7p＜0.01;LVMI in MS:(45.63±11.27)g/m^2.7vs LVMI in EH:(41.43±11.82)g/m^2.7,P＞0.05].2)The carotid resistance index and the intima-media thickness(IMT)of common carotid artery were significantly higher in MS as compared with those in DM or EH(P＜0.01)[IMT in MS:(0.95±0.22)mm vs IMT in DM:(0.77±0.29)mm,P＜0.01;IMT in MS: (0.95±0.22)mm vs IMT in EH.(0.86±0.31)mm,P＜0.01].The occurrence rate of carotid plaque was higher in patients with MS(58.15%)than that in patients with DM(42.52%), P＜0.05;The occurrence rate of carotid plaque was not different with MS(55.15%)and EH(54.36%),(P＞0.05);3)LVMI was significantly positively correlated with IMT in MS patients(r=0.281,P＜0.05).Conclusion:The degree of the left ventricular thickness in MS patients was more severethan in EH patients and DM patients;Clustering of multiple cardiovascular risk factors can cause more severe atherosclerosis of carotid artery in MS;There was significantly positive correlations between IMT and LVMI in patients with MS.