Metabolic syndrome and right ventricle: an updated review

Abstract

The cluster of metabolic and hemodynamic abnormalities which characterize the metabolic syndrome (MS) is responsible for subclinical cardiac and extra-cardiac damage such as left ventricular hypertrophy, diastolic dysfunction, carotid atherosclerosis and microalbuminuria. The development of different non-invasive imaging methods enabled a detail investigation of right ventricular structure and function, and revealed that right ventricular remodeling followed changes in the left ventricular structure and function in patients with arterial hypertension, diabetes or obesity. Previous investigations also reported that the coexistence of two components of the MS induced more significant cardiac remodeling than the presence of only one MS risk-factor. The relationship between different components of the MS (increased blood pressure, abdominal obesity, increased fasting glucose level and dyslipidemia) and right ventricular remodeling could be explained by several hemodynamic and non-hemodynamic mechanisms. However, the association between right ventricular remodeling and the MS has not been sufficiently investigated so far. The aim of this article was to review recent articles focusing on the association between metabolic syndrome components and the metabolic syndrome itself with impairments in right ventricular structure and function assessed by different imaging techniques.

Keywords: CT; Diabetes; Dyslipidemia; HDL-C; HOMA; HbA1c; Hypertension; LV; MET; MR; MS; Metabolic syndrome; Obesity; RAAS; RV; Right ventricle; SPECT; TAPSE; computed tomography; glycosylated hemoglobin; high-density lipoprotein cholesterol; homeostasis model assessment; left ventricle; magnetic resonance; metabolic equivalent; metabolic syndrome; renin–angiotensin–aldosterone system; right ventricle; single photon emission computed tomography; tricuspid annular plane systolic excursion.