Journal Article

Proarrhythmogenic Echocardiographic Markers in Metabolic Syndrome: A Cross-Sectional Study

Kitova, Lyudmila, Kitov, Spas, Kitova, Maria-Florance, Tokmakova, Mariya, Nonchev, Boyan

2025

Overview

In metabolic syndrome, cardiomyocyte changes induced by metabolic and proinflammatory factors impair repolarization and exacerbate the heterogeneity of the transmural dispersion of repolarization, and this is proarrhythmogenic. Limited data in the literature on the capabilities of speckle tracking echocardiography for assessing proarrhythmogenicity in metabolic syndrome exists. 71 patients with newly diagnosed metabolic syndrome, aged 35–55 years, were studied. Ischemic heart disease was excluded in all patients with stress test cycle ergometry, CT-angiography or selective coronary angiography. All patients underwent a 48-h Holter ECG recording. Based on the latter, they were divided into two groups: 38 patients (53.5%) with a high arrhythmogenic load (supraventricular or ventricular tachycardia, atrial fibrillation/flutter, ventricular extrasystoles over 10%, frequent supraventricular extrasystoles > 500/24 h are included); and 33 patients (46.5%) with low arrhythmogenic load (no significant rhythm disturbances are included). Echocardiography was performed with a GE Vivid T9 emphasizing global longitudinal strain, mechanical dispersion index and left atrium strains. Statistically significant differences in the global longitudinal strain, mechanical dispersion index, and left atrium strain were found between the group with low arrhythmogenicity and the group with high arrhythmogenicity (p < 0.0001). The index of mechanical dispersion has the most optimal sensitivity and specificity of all investigated echocardiographic markers. These results support the mechanical dispersion index as an additional tool for assessing proarrhythmogenicity in metabolic syndrome.

• Publisher: MDPI AG
• Subject: Angiography / Apolipoproteins / Atria / Body fat / Cardiac patients / Cardiomyocytes / Cardiovascular diseases / Echocardiography / EKG / Electrocardiogram / Electrocardiography / global longitudinal strain / Heart diseases / Heterogeneity / Ischemia / keyword metabolic syndrome / left atrial conduit strain / left atrial reservoir strain / mechanical dispersion index / Medical imaging / Medical research / Medicine, Experimental / Metabolic disorders / Metabolic syndrome / proarrhythmogenicity / Statistical analysis / Strain / Tachycardia / Ventricle