P.094 Carotid Atherosclerosis Associated to Metabolic Syndrome and Ischemic Heart Disease in Hypertensive Patients with Left Ventricular Hypertrophy

Abstract

Metabolic syndrome (MS) is one of the numerous risk factors for some patients with cardiovascular diseases. Aims: 1. to prove the presence of MS at patients with hypertension and left ventricular hypertrophy (LVH) analyzing clinical parameters; 2. to estimate the impact of MS on patient prognosis.

Method

There have been analyzed 73 hypertensive patients (43 male), average age 56.3 ± 8.5 with echocardiographically proved LVH (average LVMI 163.5 ± 31.8 g/m²).

Results

36 patients (55 ± 8 years) fulfilled the criterion of MS. They had significantly higher glucose level, lower HDL cholesterol, higher triglycerides and higher body mass index (29.6 ± 3.8 vs. 27.8 ± 3, p<0.03). This group of patients had more frequent complex VA and significantly lower values of HRV. After nine years of observation, four patients in this group had fatal CV events (3 CVI–3 deaths, 1 sudden death), while in the second group, two patients had two sudden deaths (ns).

The purpose of this study was to investigate the subclinical carotid atherosclerosis prevalence in different groups, with and without metabolic syndrome. ColourDuplex ultrasonography of the carotid arteries was performed on Acuson Sequia C236 with high-frequency linear probe with 8 MHz. The thickness of the intimomedial complex in patients with MS was 1.03 ± 0.03 vs. 0.99 ± 0.02 mm in patients without MS. Twelve patients with MS (33%) had carotid plaques, and at 43% of patients had been diagnosed coronary disease (3 IM, 2 PTCA with inbuilt stent, ten with angina pectoris and positive exercise tests), while 20% of patients with non MS had carotid plaques (p<0.04), and 9% had coronary disease (3 with angina pectoris and positive exercise tests) (p<0.002).

Conclusions

Results of our study showed that patients with LVH and MS had significantly greater prevalence of the carotid atherosclerosis and CAD, and high correlation between carotid artery disease and presence and severity of CAD.