Integrated backscatter as a fibrosis marker in the metabolic syndrome: association with biochemical evidence of fibrosis and left ventricular dysfunction

Kosmala, Wojciech, Przewlocka-Kosmala, Monika, Wojnalowicz, Anna, Mysiak, Andrzej and Marwick, Thomas H. (2012) Integrated backscatter as a fibrosis marker in the metabolic syndrome: association with biochemical evidence of fibrosis and left ventricular dysfunction. European Heart Journal Cardiovascular Imaging, 13 6: 459-467.

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Author Kosmala, Wojciech
Przewlocka-Kosmala, Monika
Wojnalowicz, Anna
Mysiak, Andrzej
Marwick, Thomas H.
Title Integrated backscatter as a fibrosis marker in the metabolic syndrome: association with biochemical evidence of fibrosis and left ventricular dysfunction
Journal name European Heart Journal Cardiovascular Imaging   Check publisher's open access policy
ISSN 2047-2404
2047-2412
Publication date 2012-06
Year available 2011
Sub-type Article (original research)
DOI 10.1093/ejechocard/jer291
Volume 13
Issue 6
Start page 459
End page 467
Total pages 9
Place of publication Oxford, United Kingdom
Publisher Oxford University Press
Collection year 2013
Language eng
Formatted abstract Aims Myocardial fibrosis is an important contributor to heterogeneity of left ventricular (LV) dysfunction in the metabolic syndrome (MS). Comparison of strain with calibrated integrated backscatter (cIB) and serological fibrosis markers could provide a means to understand the association of cardiac function with markers of fibrosis.
Methods and results We studied 172 patients with MS (age 50 ± 13years) and 61 healthy controls in a prospective, cross-sectional study. Echocardiographic evaluation included myocardial velocities and deformation, and calibrated cIB. Procollagen type III amino-terminal propeptide (PIIINP) and procollagen type I carboxy-terminal propeptide (PICP) were measured from serum. MS patients demonstrated LV systolic and diastolic function, and myocardial echodensity disturbances, as well as elevated serum PIIINP and PICP levels. For most functional variables, calibrated cIB in the basal septum was the strongest determinant of impaired LV performance, independent of higher procollagen levels, LV mass index, age, body mass index, creatinine level, and C-reactive protein. Patients with increased abdominal fat deposit (assessed by the waist-to-hip ratio) presented higher levels of procollagen peptides and septal calibrated cIB, and with more profound LV dysfunction as indicated by lower myocardial deformation and early diastolic velocity, and higher E/e′.
Conclusion Myocardial echodensity is a stronger correlate of LV systolic and diastolic dysfunction in MS, than circulating procollagen peptides. Both fibrosis and LV function abnormalities are increased at a higher waist-to-hip ratio, which might provide a rationale for the implementation of intensified therapy in this subset of patients.
Keyword Metabolic syndrome
Left ventricular function
Myocardial fibrosis
Integrated backscatter
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ
Additional Notes First published online: December 20, 2011

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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Created: Mon, 20 Aug 2012, 11:42:30 EST by Matthew Lamb on behalf of School of Medicine