Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Mar 20;24(1):128.
doi: 10.1186/s12933-025-02690-z.

The adverse effect of metabolic syndrome on left ventricular global strains and myocardial energetic efficiency in non-ischemic dilated cardiomyopathy patients: a cardiac magnetic resonance study

Meng-Ting Shen  1 , Yuan Li  1 , Ke Shi  1 , Jin Wang  1 , Li Jiang  1 , Yu Jiang  1 , Yue Gao  1 , Shi-Qin Yu  1 , Xue-Ming Li  1 , Wei-Feng Yan  1 , Zhi-Gang Yang  2
Affiliations

The adverse effect of metabolic syndrome on left ventricular global strains and myocardial energetic efficiency in non-ischemic dilated cardiomyopathy patients: a cardiac magnetic resonance study

Meng-Ting Shen et al. Cardiovasc Diabetol. .

Abstract

Background: Metabolic syndrome (MetS) is a known risk factor for cardiovascular dysfunction; however, its impact on left ventricular (LV) global strains and myocardial energetic efficiency in non-ischemic dilated cardiomyopathy (NIDCM) remains inadequately understood. This study aimed to investigate the effect of MetS on LV dysfunction in NIDCM patients using cardiovascular magnetic resonance (CMR) imaging.

Methods: A total of 557 NIDCM patients (378 without MetS and 179 with MetS) who underwent CMR examination were included. CMR-derived LV strains, remodeling index (LVRI), global function index (LVGFI), and indexed myocardial energetic efficiency (MEEI) were assessed and compared between the groups. The independent determinants of LV global longitudinal peak strain (GLPS), LVRI, LVGFI, and MEEI were evaluated using multivariable linear regression analyses.

Results: Compared to NIDCM patients without MetS, those with MetS had significantly lower LVSVI, LVEF, and LVGFI, along with higher LVMI and LVRI (all p < 0.05). However, no significant differences were found in LVEDVI and LVESVI (both p > 0.05). In terms of LV strain, the NIDCM(MetS+) group exhibited worse global peak strain and peak diastolic strain rate in all three directions, as well as decreased radial and longitudinal peak systolic strain rate (PSSR) compared to the NIDCM (MetS-) group (all p < 0.05), while circumferential PSSR did not differ significantly (p > 0.05). The MEEI was significantly lower in the NIDCM(MetS+) group compared to the NIDCM(MetS-) group (0.30 [0.20, 0.45] ml/s/g vs. 0.39 [0.25, 0.58] ml/s/g, p < 0.001). Multivariable analysis identified the presence of MetS as an independent determinant of LV GLPS (β = 0.211, p < 0.001), LVRI (β = 0.147, p = 0.003), and MEEI (β = - 0.160, p < 0.001).

Conclusion: The presence of MetS worsens LV function, remodeling, and myocardial energetic efficiency in patients with NIDCM, as evidenced by declines in LV strain, global function parameters, and indexed myocardial energetic efficiency. These findings suggest that addressing metabolic abnormalities may be crucial for improving LV function and outcomes for patients with NIDCM.

Keywords: Magnetic resonance imaging; Metabolic syndrome; Myocardial energetic efficiency; Myocardial strain; Non-ischemic dilated cardiomyopathy.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study protocol was approved by the Biomedical Research Ethics Committee of our hospital. Informed consent was waived due to the retrospective nature of the research. The patient-sensitive data were protected with full confidentiality. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Measurement of LV global peak strain. MR tissue tracking in short-axis (A), and long-axis 2-chamber (B), 4-chamber (C) cine images at end-diastole. The 3-dimensional pseudo-color maps of LV global peak strain in radial (D), circumferential (E), and longitudinal (F) directions
Fig. 2
Fig. 2
Two groups of the representative CMR imaging. LV pseudo-color images of short-axis(A1 and A2), long-axis four‐(B1 and B2) and two‐chamber(C1 and C2) cine images at the end‐diastole and CMR imaging derived the global radial(D1 and D2), circumferential(E1 and E2), and longitudinal(F1 and F2) peak strain curves. A1–F1 a NIDCM(MetS+) subject, A2–F2 a NIDCM(MetS−) patient
See this image and copyright information in PMC

References

    1. Sperling LS, Mechanick JI, Neeland IJ, Herrick CJ, Després JP, Ndumele CE, et al. The cardiometabolic health alliance: working toward a new care model for the metabolic syndrome. J Am Coll Cardiol. 2015;66(9):1050–67. - PubMed
    1. Reaven G. Metabolic syndrome: pathophysiology and implications for management of cardiovascular disease. Circulation. 2002;106(3):286–8. - PubMed
    1. Min CY, Gao Y, Li Y, Jiang YN, Guo YK, Xu HY, et al. The additional impact of metabolic syndrome on left ventricular deformation and myocardial energetic efficiency impairment in ischemia with nonobstructive coronary arteries patients. Cardiovasc Diabetol. 2025;24(1):26. - PMC - PubMed
    1. Min CY, Gao Y, Jiang YN, Guo YK, Shi K, Yang ZG, et al. The additive effect of metabolic syndrome on left ventricular impairment in patients with obstructive coronary artery disease assessed by 3.0 T cardiac magnetic resonance feature tracking. Cardiovasc Diabetol. 2024;23(1):133. - PMC - PubMed
    1. Flam E, Jang C, Murashige D, Yang Y, Morley MP, Jung S, et al. Integrated landscape of cardiac metabolism in end-stage human nonischemic dilated cardiomyopathy. Nat Cardiovasc Res. 2022;1(9):817–29. - PMC - PubMed

MeSH terms

LinkOut - more resources