Association of Metabolic Syndrome with Types of Heart Failure in Patients Referred to Hawler Teaching Hospital

Authors: Abdulkareem Al-Othman & Zana Ahmed

Abstract:  Metabolic syndrome consists of some risk factors that are associated with heart failure. It has been found that it is significantly associated with mortality in patients having heart failure. This study aimed to assess the prevalence of metabolic syndrome among patients with symptomatic stages C or D of heart failure and find out any possible association of metabolic syndrome with different types of heart failure. Between December 2017 and June 2018; 50 patients were included in a cross-sectional study. Careful history was taken and clinical examination was done to conclude that they fulfill the Framingham’s criteria of heart failure and then trans-thoracic echocardiography was performed to confirm the diagnosis and categorize the patients to have failure with preserved, mid-range and reduced ejection fraction. Waist circumference, plasma glucose, blood pressure and lipid profile checked to find out whether they have metabolic syndrome or not. Statistical analysis was conducted using (version 22) and a p-value <5 % was regarded as statistically significant. Metabolic syndrome was observed in 38 (76%) of the patients, but its prevalence was not statistically different between the types of heart failure; as its prevalence was 83.3 % in heart failure with preserved ejection fraction, 75 % in mid-range ejection fraction, and 71.4 % in reduced ejection fraction. Metabolic syndrome is highly existent among patients with heart failure, but there is no considerable difference in its existence among the different types of heart failure.

Keywords: Metabolic Syndrome, Heart Failure, Ejection Fraction, Central Obesity, Dyslipidaemia, Hyperglycaemia, Hypertension, Echocardiography
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doi: 10.23918/eajse.v4i2p74


Alwan, A. (2004). Health in Iraq-The Current Situation, Our Vision for the Future and Areas of Work (2nd ed.). Iraq

American Diabetes Association. (2018). Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes. Diabetes Care, 38(Supplement 1), 8-16.

Ansarimoghaddam, A., AliAdineh, H., Zareban, I., Iranpour, S., HosseinZadeh, A., & Framanfarma, Kh. (2018). Prevalence of metabolic syndrome in Middle East. Clinical Research & Reviews. 12(2), 195-201.

Biagi, P., Nardi, R., Mathieu, G., Vescovo, G., & Scanelli, G. (2014). Metabolic syndrome and heart failure. Italian Journal of Medicine, 8(3), 169-75.

Breathett, Kh., Allen, L.A., Udelson, J., Davis, G., & Bristow, M. (2016). Changes in LVEF predict survival and hospitalization in HFrEF. Circulation: Heart Failure, 9(10), 1-11.

Feigenbaum, H. Armstrong W. F. & Ryan T (Eds.). (2004). Feigenbaum’s Echocardiography. (6th ed.). USA: Lippincott Williams & Wilkins.

Filardi, P. P., Paolillo, S., Costanzo, P., Savarese, G., Trimarco, B., & Bonow, R. O. (2015). The role of metabolic syndrome in heart failure. European Heart Journal, 36(39), 2630–2634.

Hübers, M., Pourhassan, M., Braun, W., Geisler, C., & Müller, M. (2017). Definition of new cut-offs of BMI and waist circumference based on body composition and insulin resistance. Obesity Science & Practice, 3(3), 272–281.

Ingelsson, E., Ärnlöv, J., Lind, L., & Sundström, J. (2006). Metabolic syndrome and risk for heart failure in middle-aged men. Heart, 92(10), 1409-1413.

Institute for Health Metrics and Evaluation. (2018). Retrieved on July 18, 2018, from

International diabetes federation. (2006). The IDF consensus worldwide definition of the Metabolic syndrome. Belgium, 10.

Miura, Y., Fukumoto, Y., Shiba, N., Miura, T., Shimada, K., Iwama, Y., …& Shimokawa, H. (2010). Prevalence and clinical implication of metabolic syndrome in chronic heart failure. Circulation Journal,74(12), 2612-2621.

Mosterd, A., Hoes, A.W., de Bruyne, M.C., Deckers, J.W., Linker, D.T., Hofman, A., & Grobbee, D. E. (2009). Prevalence of heart failure and left ventricular dysfunction in the general population. European Heart Journal, 20(6), 447-455.

Peña, M. B., Swett, K., Schneiderman, N., Spevack, D.M., Ponce, S. G., Talavera, G. A.,…& Rodriguez, C.J. (2018). Cardiac structure and function with and without metabolic syndrome. BMJ Open Diabetes Research & Care, 6(1), 1-10.

Ponikowski, P., Voors, A. A., Anker, S. D., Bueno, H., Cleland, J. F., Coats, A., … & Meer, P. (2016). ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. European Heart Journal, 37(27), 2129–2200.

Tamariz, L., Hassan, B., Palacio, A., Arcement, L., Horswell, R., & Hebert, K. (2009). Metabolic syndrome increases mortality in heart failure. Clinical cardiology, 32(6), 327–331.

Whelton, P., Carey, R. M., Aronow, W.S., Casey, D. E., Collins, K.J., Himmelfarb, C. D., …& Wright, J. T. (2018). A Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults. Hypertension,71(19), 127 – 248.