Evaluation of the relationship between left ventricular mechanical dispersion and cardiac electrophysiological balance index in metabolic syndrome patients

Introduction and Aim: Metabolic syndrome (MetS) is an endocrinologic disorder with both metabolic and physiologic components, including abdominal obesity, hypertension (HT), low high-density lipoprotein cholesterol (HDL-C), hyperglycemia and hypertriglyceridemia. The diagnosis of MetS is based on the presence of at least three of these components at the same time. The prevalence of MetS is approximately 22% in adults and increases with age. More than half of individuals who develop CAD also have MetS. Previous studies have shown an association between MetS and left ventricular (LV) dysfunction. In this study, we aimed to test whether left ventricular mechanical dispersion (SoVMD) and cardio-electrophysiologic balance index (CEBI), which are new markers that may predict subclinical cardiac dysfunction in MetS patients, are different in patients with and without MetS and to test the correlation between each other. Method: In this prospective data collection study, 58 MetS patients aged 18-65 years and 56 age/sex-matched controls aged between 18 and 65 years who applied to the Cardiology outpatient clinic of Inonu University Turgut Özal Medical Centre were included. Socio-demographic characteristics of both groups were analysed. Standard electrocardiograms were evaluated, QT distance, corrected QT value according to Bazett formula and QRS duration were calculated. QT and corrected QT values were divided by QRS duration and cardiac electrophysiological balance index and corrected cardiac electrophysiological balance index were calculated. Conventional echocardiographic examination of the groups was performed and left ventricular global strain (LVGS) and LVMD were evaluated by 2-dimensional (2D) speckle tracking echocardiography. The correlation between CEBİ and LVMD and the differences between MetS patients and the control group were analysed. Results: In the present study, it was observed that the value of CEBİc was higher in MetS patients compared to the healthy control group (5,11 ± 0,35 vs 4,65 ± 0,56, p < 0,001). LVMD obtained with 2D strain was also higher in MetS patients (41,1 ± 9,6 vs 20,1 ± 6,4, p < 0,001). There was a moderate correlation between LVMD and CEBİc (r = 0,488, p < 0,001). Among the components of MetS, especially the increase in waist circumference was found to be more correlated with CEBİc and LVMD (r = 0,523, p < 0,001). There was a low-moderate correlation (r = 0,360, p = 0,006) between triglyceride level and CEBİc. There was a low-moderate correlation (r = -0,270, p = 0,040) between HDL level and CEBİc. Multiple linear regression analysis showed that the presence of HT (ß = 7,443(3,371-11,515), waist circumference (ß = 0,195(0,043-0,346) and TG (ß = 11,055(6,889-15,221)) were independent predictors of CEBİc, while the presence of DM (ß = 0,297(0,088-0,505) and TG (ß = 0,242(0,040-0,443) were independent predictors of LVMD. Conclusion: In conclusion, in this study, we found that the values of CEBİc and LVMD were higher in patients with MetS. Higher values of CEBİc in patients with MetS may be an indicator of LV dysfunction and should therefore be followed closely. Keywords: Metabolic syndrome, Cardiac-electrophysiological balance index, Peak systolic dispersion, Mechanical dispersion