Evaluation Of Right Ventricular Function In Patients With Metabolic Syndrome Using Two-Dimensional Speckle Tracking Imaging And Real-Time Three-Dimensional Echocardiography

Objective To evaluate right ventricular function in patients with metabolic syndrome(MS) using two-dimensional speckle tracking ima ging(2D-STI) and real-time three-dimensional echocardiography(RT-3D E), and then to explore the correlations between different MS criteria and right ventricular function.Methods Seventy-nine patients were devided into two groups a ccording to the number of MS criteria, including pre-metabloic syndr ome(Pre-MS) group(1~2 criteria,n=35) and MS group(≥3 criteria,n=44). Forty healthy volunteers were enrolled as control group.The basal,middle, apical systolic and diastolic longitudinal peak strain(Ss) and s train rate(SRs,SRe,SRa) of right ventricular free wall were measured using 2D-STI and global strain and strain rate(GSs,GSRs,GSRe,GSR a) of right ventricle were calculated. The right ventricular end-diastoli c volume, end-systolic volume, stroke volume and ejection fraction(E DV,ESV,SV,EF) were measured by RT-3DE, then to calculate the enddiastolic volume index and end-systolic volume index(EDVI,ESVI) re vised by body surface area. The correlations between different MS criteria and GS, GSR,EF of right ventricle were analyzed.Results(1)Compared with control group, Ss, SRs, SRe and SRa in basal and middle segments in MS group and Ss, SRs in basal se gment in Pre-MS group decreased(all P<0.05).Ss, SRs in basal segme nt in MS group were significantly lower than those in Pre-MS group(all P<0.05).Compared with control group, GSs,GSRs,GSRe and GSR a in MS group and GSs,GSRs in Pre-MS group decreased(all P<0.05).GS,GSR in MS group and Pre-MS group had no statistical signific ance(all P>0.05).(2)Compared with control group,EDV,ESV,EDVI and ESVI increased significantly and EF decreased significantly in the Pr e-MS and MS groups(all P<0.05). EDVI and EF were similar betwee n Pre-MS and MS groups(all P>0.05),whereas the EDV,ESV and ES VI increased significantly in MS group(all P<0.05).(3)There were g ood correlations of waist circumference(WC),systolic blood pressure(S BP),fasting blood-glucose(FBG) with GSs(r=-0.73,-0.69,-0.46,all P<0.01),GSRs(r=-0.63,-0.78,-0.48,all P<0.01) and EF(r=-0.78,-0.76,-0.54,all P<0.01).The multiple regression analysis of MS criteria showed that W C was independently associated with GSs and EF(β=-0.44,-0.49,all P<0.01) of right ventricle and SBP was independently associated with GSRs of right ventricle(β=-0.77,P<0.01).Conclusions With the increasing of metabolic criteria,there is a progressive deterioration of right ventricular function.2D-STI and RT-3DE could assess accurately right ventricular function in MS patients. Among all metabolic criteria, WC and SBP are the most responsible for right ventricular function,which has important clinical significance to guide the treatment of MS patients.