Abstract:
Introduction: Metabolic Syndrome (MetS), characterized by a cluster of conditions such as obesity, hypertension, insulin resistance, and dyslipidemia, has been increasingly linked to cardiovascular complications. While its association with heart disease is well known, its specific impact on the prognosis of heart failure (HF), especially in middle-aged individuals, remains inadequately studied. This study aimed to evaluate how MetS influences heart failure outcomes in terms of morbidity and mortality.
Methods: The study enrolled 100 middle-aged patients suffering from moderate to severe heart failure, all of whom had an ejection fraction (EF) ≤ 40% and QRS duration ≥ 130 ms. Of these, 60 had metabolic syndrome and 40 did not. All patients received standard heart failure therapy and were followed for a period of 24 weeks.
Primary endpoints included:
- Change in New York Heart Association (NYHA) class
- Six-minute walk test (6MWT) distance
Secondary endpoints included:
- Left Ventricular Ejection Fraction (LVEF)
- Left Ventricular End-Diastolic Diameter (LVEDD)
- Systolic Pulmonary Artery Pressure (SPAP)
- QRS duration
Results: Patients without metabolic syndrome showed better clinical outcomes compared to those with
MetS. Specifically:
- 6MWT distance: Non-MetS patients improved significantly, walking an average of 336.40 meters vs. 285.35 meters in the MetS group.
- NYHA class improvement: 75% of patients without MetS improved by at least one
- NYHA class, compared to just 33.3% of MetS patients.
- LVEF improvement: The MetS group had a smaller increase in LVEF (from 31.63% to
- 35.22%) compared to the non-MetS group.
- Hospitalizations and medications: MetS patients required more frequent hospital admissions and IV drug support (50% vs. 10%).
Conclusion: This study strongly indicates that the presence of metabolic syndrome in heart failure patients significantly hampers recovery. Compared to those without MetS, patients with the syndrome showed limited functional and echocardiographic improvement despite receiving similar therapy. These findings suggest that MetS is not only a comorbidity but also a negative prognostic factor in heart failure. Clinicians should closely monitor heart failure patients with MetS and consider more aggressive risk factor modification early in the disease course.
Keywords: Metabolic syndrome, heart failure, prognosis, ejection fraction, NYHA class, South
Indian population
