High frequency of metabolic disorders in the population demands a study of their consequences for the cardiovascular system.
OBJECTIVE
To study the structural and functional parameters of the myocardium in residents of Arkhangelsk with different metabolic phenotypes and reveal factors associated with their deviations.
MATERIALS AND METHODS
We analyzed the data of a cross-sectional study «Know your heart» (2015—2017, Arkhangelsk, n=2352, 35—69 years). The participants were divided by phenotypes depending on the obesity status (body mass index ≥30 kg/m2) and the presence of two or more metabolic syndrome criteria (AHA/NHBLI, 2009): phenotype 1 — «metabolically healthy without obesity» (reference group), 2 — «metabolically unhealthy without obesity», 3 — «metabolically healthy obesity», 4 — «metabolically unhealthy obesity». The anamnestic, anthropometric, laboratory, and instrumental data was assessed.
RESULTS
Most (89.4%) participants had a preserved (≥50%) left ventricular (LV) ejection fraction. The sizes of the left atrium, LV, right ventricle and indexed LV myocardial mass (LVMI) were significantly greater in obese people (phenotypes 3, 4) compared to the reference group. LV functional parameters were statistically significant lower (e′ lateral, e′ septal, E/A ratio, GLS) or higher (E/e′) in individuals with phenotypes 2, 3, or 4. Tricuspid annular plane systolic escursion (TAPSE) was lower in individuals with metabolic disorders (phenotypes 2, 4). Individuals with phenotype 3 represented independent associations of hypertension with increased LVMI (p=0.002) and E/e′ (p=0.028), as well as low-gradient inflammation — with a decrease in TAPSE (p=0.010). In phenotype 2, abdominal obesity independently correlated with an increase in LVMI (p=0.011) and a decrease in GLS (p=0.003), and a decrease in high-density lipoprotein levels — with an increase in LVMI (p=0.010).
CONCLUSION
The structural and functional parameters of the myocardium in residents of Arkhangelsk were for the first time described within the framework of the concept of metabolic phenotypes. Various factors indicating possible different pathways for the formation of diastolic dysfunction in different phenotypes were described.
