Abstract:Objective Two-dimensional spot tracking imaging (2D-STI) was used to evaluate the changes in right ventricular systolic function in patients with metabolic syndrome (MS) and to explore the relationship between the changes and epicardial fat thickness.Method In this study,100 participants (65 in MS patients and 35 in the control group) underwent routine echocardiography and two-dimensional spot tracking to compare the differences in clinical and ultrasonic indicators between the two groups.Pearson and Spearman correlation coefficients were used to analyze the correlation between FWS and metabolic factors.Multiple linear regression was used to analyze the independent influencing factors of FWS.Bootstrap method was used to analyze whether some clinical indicators mediated the association between EAT and FWS.Result RVGLS and RVFWS in MS group were lower than those in control group(P<0.05);FWS in case group was negatively correlated with EAT,age,systolic blood pressure,diastolic blood pressure,BMI,waist-height ratio,GLU,TG,LDL-C and TC,and positively correlated with HDL-C (P<0.05);EAT,systolic blood pressure,GLU,TG and HDL-C were independent influencing factors of FWS (P<0.05);EAT has a direct effect on FWS,and systolic blood pressure,GLU,TG,HDL-C partially mediate the effect of EAT on FWS.Conclusion Compared with conventional echocardiography,2D-STI can detect early right ventricular systolic dysfunction more sensitively and accurately in MS patients.In MS patients,EAT was an independent influencing factor of FWS;EAT partially mediates its toxic effects on the right ventricle through circulatory metabolism.