Role of Mitogen-Activated Protein Kinase Pathways in Multifactorial Adverse Cardiac Remodeling Associated with Metabolic Syndrome

Table 1

Different disorders in metabolic syndrome are associated with cardiac structural and functional changes.

Metabolic syndrome characteristic	Adverse cardiac remodelling	Reference	Method of assessment
	Obese women have higher end-diastolic septal and posterior wall thickness, left ventricle mass, and relative wall thickness than nonobese	[13]	Echocardiography and tissue Doppler imaging
Obesity	Uncomplicated severe obesity is associated with adapted and appropriate changes in cardiac structure and function	[14]	Echocardiography
	Reduced left ventricle systolic and diastolic function and increased myocardial reflectivity characterize obese patients as compared to referents	[15]	Transthoracic echocardiography, myocardial Doppler-derived systolic and early diastolic velocity, strain and strain rate imaging, and tissue characterization with cyclic variation and calibrated integrated backscatter
	Diabetes, fasting glucose, and fasting insulin levels are associated with left ventricular hypertrophy	[16]	Echocardiography and laboratory testing
Diabetes	Increased heart size in obese men	[17]	Autopsy
	Postmortem analysis of obese patients that died from gastric bypass complication revealed cardiac hypertrophy	[18]	Autopsy
Hypertension	Left ventricle mass is positively associated with the number of metabolic risk factors in normotensive and hypertensive participants	[19]	Echocardiography
	Increased left ventricular mass and reduce left ventricular relaxation	[20]	Echocardiography was used to assess pulse-wave Doppler and tissue Doppler imaging
Metabolic syndrome; (defined as a cluster of all previously cited disorders [2])	Ventricular diastolic dysfunction, mean left ventricular mass, and left ventricular diameter significantly increase with the number of features of the metabolic syndrome	[21]	Structured clinical interview with a physician, ECG and a transthoracic M-mode, and 2D echocardiogram
	High levels of IL-6 that could be observed in metabolic syndrome induce cardiac fibrosis	[22]	Blood-perfused isolated heart
	Cardiotrophin-1 treatment, mimicking the upregulated level found in metabolic syndrome, induces cardiac fibrosis	[23]	Echocardiography, Doppler, and echo tracking device and ex vivo approach