Clinical Study Of Noninvasive Cardiac Hemodynamics On Metabolic Syndrome

With the social development and lifestyle changes, metabolic syndrome have become one of the most important disease which affect human health, its prevalence rate was significantly increased. The performance of metabolic syndrome is multiple metabolic risk factors gathered in the same individual, which make the significant increase of cardiovascular disease. Metabolic syndrome related risk factors through interaction and ultimately can cause cardiovascular damage, leading to abnormal of structure and function. Changes in cardiac function earlier than structural changes, the fundamental measure of control cardiovascular events is the early detection and intervention in cardiovascular risk factors. Thoracic electrical bioimpedance has a long history, As a non-invasive, simple method to determine hemodynamics and cardiac function method through continuous improvement, and its role is increasingly attracting the attention. Although some research has already done on non-invasive hemodynamic monitoring for determination of heart function by Domestic and foreign scholars, Most are a few indicators of a disease (such as hypertension), and metabolic syndrome and cardiovascular related risk factors in combination on heart function have rarely been studied. This study analyzed the characteristics of cardiac hemodynamics on metabolic syndrome, and the effect of central obesity, dyslipidemia, hypertension and abnormal glucose metabolism on cardiac function, so as to determine the value of non-invasive hemodynamic monitoring system in the metabolic syndrome and related risk factors and to provide the basis for prevention and treatment of metabolic syndrome.Objective1. This study is to explore the characteristics of noninvasive cardiac hemodynamics on metabolic syndrome.2. To observe the effect of cardiovascular risk factors of metabolic syndrome on the cardiac hemodynamics, and to discuss the sensitive indicators to determine the early cardiac dysfunction by Lifegard ICG Hemodynamic Monitor.Method363 individuals of which 237 cases is men and 126 cases is women aged 31 to 87 years, mean age (57.55±11.99) years old, were divided into four groups included the health controls group (n=30), one metabolic syndrome related risk factors group (n=107, including central obesity group, the high TG group, low HDL-C group, hypertension group and hyperglycemia group), two metabolic syndrome related risk factors group (n=127, including central obesity combined with high TG group, central obesity combined with low HDL-C group, central obesity combined with hypertension group, central obesity combined with hyperglycemia group, and hypertension combined with hyperglycemia group), and the metabolic syndrome group (n=99). The body mass index (BMI), waist circumference (WC), fasting blood glucose (FBG), triglycerides (TG), total cholesterol (TC), high densitylipoprotein cholesterol (HDL-C), low densitylipoprotein cholesterol (LDL-C), systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP) and mean arterial pressure (MAP) were measured on all subjects. Cardiac output (CO), cardiac index (CI), systemic vascular resistance (SVR), systemic vascular resistance index (SVRI), stroke volume (SV), stroke index (SI), thoracic fluid content (TFC), acceleration index (ACI), left cardiac works index (LCWI), pre-ejection period (PEP), left ventricular ejection time (LVET), velocity index (VI), contraction time ratio (STR) and heart rate (HR) were measured using Lifegard ICG Hemodynamic Monitor.Results1. Compared with the healthy controls group, there was significant difference in ACI, VI and LVET of patients with one metabolic syndrome related risk factors group, two metabolic syndrome related risk factors group and the metabolic syndrome group (P<0.05 or P<0.01).2. Compared with the healthy controls group, there was significant differences in the ACI, VI, SVR and SVRI of hypertension group (P<0.05 or P<0.01); there was significant difference in the ACI, VI and LVET of central obesity group (P<0.05 or P<0.01) and VI in the high triglycerides group (P<0.05)3. Compared with central obesity complicated with high triglycerides group, SVR and SVRI are significant higher than the value of central obesity complicated with hypertension, hypertension complicated with hyperglycemia group, while CO and CI are lower (P<0.05 or P<0.01); the value of LCWI is lower in the central obesity complicated with hyperglycemia group (P<0.05); the SV value of hypertension complicated with hyperglycemia is significant lower (P<0.01).4. The metabolic syndrome group is divided into male group and female group. CO, CI, SV, TFC, LCWI of female group are lower than the male group (P<0.05 or P<0.01); while the value of SVR is higher (P<0.05)5. Compared with the young-MS group, CO and SV are gradually lower than the middle aged-MS group, the old aged-MS group and the advanced aged-MS group (P<0.05 or P<0.01); CI, SI, PEP,LVET of advanced aged-MS group are lower than the young-MS group (P<0.05 or P<0.01); SVR of middle aged-MS group and old aged-MS group is higher than the young-MS group (P<0.05).6. Correlation analysis:SI related negatively with AGE, SBP, DBP, PP, MAP and HR (P<0.05 or P<0.01); SVRI related positively with AGE, SBP, DBP, PP, MAP and negatively with HR (P<0.01); ACI related negatively with AGE, BMI, WC, FBG, SBP, DBP, MAP, HR and positively with HDL-C (P<0.05 or P＜0.01); VI related negatively with AGE, BMI, WC, FBG, TG, SBP, DBP, MAP, HR and positively with HDL-C (P<0.05 or P<0.01); LVET related negatively with AGE, BMI, WC, SBP, PP, MAP and HR (P<0.05 or P<0.01) Conclusion1. Patients of metabolic syndrome exist the decreased myocardial contractility, left ventricular pump dysfunction and increased vascular resistance load.2. Age, central obesity, hypertriglyceridemia, hypertension and abnormal glucose metabolism and other risk factors have great effect on the cardiac hemodynamics for the index of myocardial contractility reduction, such as ACI and VI. In this study, the effect of the high-density lipoprotein cholesterol on cardiac hemodynamics is not clear.3. Central obesity as an essential factor in diagnosis of metabolic syndrome, the impact on cardiac hemodynamics mainly in AVI, VI, LVET decreased, suggesting that central obesity as a risk factor that lead to diminished myocardial contractility.4. Only wih the presence of 1-2 metabolic syndrome related risk factors, ACI, VI, LVET, SI, SVRI and other cardiac hemodynamics have different degrees of abnormality; with increased risk factors for metabolic syndrome, myocardial contractility, pump function and cardiac afterload are worsening, and increased the risk of heart damage.5. ACI, VI and LVET are the indicator of myocardial contractility, the decrease can be used to monitor the early abnormal of cardiac hemodynamics as non-invasive and sensitive index.