Among the echocardiographic parameters, Sm is the most representative paramenter which is able to evaluate myocardial dysfunction in MS in present study. A correlation index of Sm greater than 0.3 was seen in waist circumference and SBP. Table 4 Correlation coefficients between clinical and echocardiographic parameters TG and HDL levels did not have significant correlations with any of the echocardiographic parameters. Stepwise multiple regression analysis

was performed to examine the clinical parameters that influence global Sm (Table 5). Inhibitors,research,lifescience,medical The results indicated that age (β coefficient = -0.313, p = 0.006), waist circumference (β coefficient = -0.296, p = 0.012), and SBP (β coefficient = -0.253, p = 0.031) were independently associated with Sm. Table 5 Multiple regression analyses to examine the clinical parameters that influence global Sm Discussion The results of our study showed that non-hypertensive MS patients had subclinical myocardial dysfunction that Inhibitors,research,lifescience,medical was made apparent by TDI. Previous studies have

shown echocardiographic evidence of myocardial dysfunction in MS patients.11),12) However, most patients enrolled in those studies had overt DM or HT. Thus, diastolic dysfunction was evident by conventional parameters (E, A, and E/A) as well as TDI indices. In contrast, the present study shows that myocardial dysfunction in patients with an early stage of MS was detected Inhibitors,research,lifescience,medical by TDI not conventional parameters. We designed this study to test the hypothesis that early MS patients might have myocardial dysfunction. We excluded HT patients to estimate the true impact of early stage MS on myocardial function, Inhibitors,research,lifescience,medical which was the most important aspect of the present

study. In Duvelisib manufacturer addition, a study of MS patients without DM or HT lends itself to a better examination of the relationship between each metabolic parameter to myocardial function, because HT by itself is strong enough to cause a decline Inhibitors,research,lifescience,medical in diastolic function. Peak longitudinal myocardial velocities derived from pulsed wave TDI are useful indicators of global or regional LV dysfunction. The early diastolic TDI velocity of the mitral annulus is generally thought to be a preload independent index for LV relaxation, and it is used to estimate LV filling pressures.22),23) Strain and strain rate are other tools that can reflect myocardial function.24),25) We applied tissue Doppler myocardial velocity, strain, and strain rate together to detect subtle changes ADAMTS5 in global myocardial function. Conventional Doppler echocardiography revealed a tendency for MS patients to have more diastolic LV dysfunction. However, that tendency did not achieve statistical significance. In contrast, TDI studies showed significant differences that were not revealed by conventional pulsed wave Doppler studies. Lateral Ea velocity, Sm, Em, Ssr, Esr, and PSS were more profoundly decreased in the MS group compared to control, and the differences achieved statistical significance.