Regional myocardial function abnormalities are associated with macro- and microcirculation dysfunction in the metabolic syndrome: the RESOLVE study

• Published in: Heart and vessels Vol. 33; no. 6; pp. 688 - 694
• Main Authors: Obert, Philippe, Walther, Guillaume, Dutheil, Frédéric, Lesourd, Bruno, Chapier, Robert, Courteix, Daniel, Vinet, Agnes
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01-06-2018; Springer Nature B.V; Springer Verlag
• Subjects: Abnormalities; Acetylcholine; Arteries; Biomedical Engineering and Bioengineering; Blood flow; Cardiac Surgery; Cardiology; Cardiology and cardiovascular system; Circulatory system; Dilation; Doppler effect; Endothelium; Forearm; Heart; Human health and pathology; Iontophoresis; Life Sciences; Medicine; Medicine & Public Health; Metabolic syndrome; Microvasculature; Muscle function; Muscles; Pathogenesis; Patients; Short Communication; Skin; Smooth muscle; Sodium; Sodium nitroprusside; Vascular Surgery; Veins & arteries; Ventricle; Myocardial function; Metabolic syndrome; Smooth muscle function; Endothelium
• ISSN: 0910-8327; 1615-2573
• DOI: 10.1007/s00380-017-1108-y

Abnormalities in myocardial and vascular function have been reported in the metabolic syndrome (MetS), but whether these alterations are related remains poorly documented. Our aim was accordingly to investigate interrelationships between macro- and microcirculatory vasoreactivity and left ventricular (LV) myocardial function in MetS patients. Eighty-eight MetS individuals and 44 age- and gender-matched healthy controls were enrolled. LV global longitudinal strain (GLS) was measured using Vector Velocity Imaging. Endothelial-dependent and independent reactivity in macro- and microcirculatory territories was established using flow-mediated dilation and nitrate-mediated dilation of the brachial artery and cutaneous blood flow measured with laser Doppler flowmetry in response to iontophoresis of acetylcholine and sodium nitroprusside, respectively. Carotid intima-media thickness (cIMT) was measured according to the Mannheim consensus. Compared to controls, MetS patients presented with reduced GLS (
p
 < 0.001) increased cIMT and impaired (
p
 < 0.001) endothelial and smooth muscle function of the brachial artery and the forearm skin microcirculation. Highly significant relationships (
p
 < 0.01) were noticed between GLS and vascular outcomes. In addition, cIMT (
β
 = 0.21,
p
 = 0.024) and microcirculatory endothelium-dependent reactivity (
β
 = − 0.20,
p
 = 0.035) were identified as independent predictors of GLS. In MetS, abnormalities in myocardial function and endothelial as well as smooth muscle function of small and large arteries co-exist and are closely associated. This study supports a role for microvascular dysfunction in the pathogenesis of LV myocardial dysfunction.