Dose-response relationship between metabolic disease burden and myocardial deformation: a confounder-adjusted linear regression analysis

Abstract

Metabolic diseases are increasingly recognized as contributors to cardiac dysfunction, but the dose–response relationship between metabolic disease burden and myocardial deformation remains unclear. This single-center retrospective study included ST-segment elevation myocardial infarction (STEMI) patients who underwent echocardiography with strain analysis. Patients were stratified by the number of metabolic disorders (0, 1,2, or 3). Multiple linear regression models were used to assess the independent association between metabolic disease burden and myocardial deformation parameters, with sequential adjustment for sociodemographic, clinical, and therapeutic variables. A greater burden of metabolic diseases was independently associated with reduced left ventricular global longitudinal strain (LVGLS), as well as decreased left atrial reservoir (LASr), contractile (LASct), and conduit (LAScd) function. These associations followed a dose–response pattern and remained significant after full adjustment. In contrast, the associations with right ventricular global longitudinal strain (RVGLS) and right ventricular free wall strain (RVFWS) were attenuated and became non-significant after adjusting for basic covariates. Metabolic disease burden was independently associated with impaired left heart myocardial deformation in a dose-dependent manner. The association with right ventricular dysfunction was less robust, suggesting a potential hierarchy of cardiac chamber involvement. 1. Focus on synergistic damage of multisystem metabolic abnormalities 2. Address the scarcity of dose-response relationship studies 3. Incorporate neglected RV and atrial strain parameters