Subclinical Left Ventricular Dysfunction in Women with Polycystic Ovary Syndrome

Abstract

Aims Cardiac involvement has been increasingly recognized in patients with polycystic ovary syndrome (PCOS). Identification of the earliest asymptomatic impairment of left ventricular (LV) performance may be important in preventing progression to overt heart failure. Our aim was to investigate LV function with different echocardiographical techniques in patients with PCOS.

Methods Thirty patients with PCOS and 30 age and body mass index matched healthy subjects were enrolled to this cross-sectional observational study. All subjects underwent echocardiography for assessment of resting LV function. Global longitudinal strain (GLS) was calculated from 3 standard apical views using two-dimensional speckle tracking echocardiography (2D-STE).

Results The early mitral inflow deceleration time (DT), isovolumetric relaxation time (IVRT) and E/Em ratio was increased in the PCOS group. Waist-to-hip ratio, fasting insulin, HOMA-IR and LDL levels were higher in PCOS group. Significant correlation was observed between DT, IVRT and insulin value, HOMA-IR. On real time three-dimensional echocardiography (3D-RTE) evaluation, none of the patients in both groups had LV systolic dysfunction with comparable LVEF and LV volumes. 2D-STE showed that GLS was significantly reduced in the PCOS group compared to control group (-16.78±0.56% vs. -18.36±1.04%, p<0.001). The GLS was found to be negatively correlated with waist-to-hip ratio and LDL values.

Conclusıon These results indicate that PCOS may be related to impaired LV systolic function detected by 2D-STE. In addition, PCOS may lead to diastolic dysfunction. Reduced GLS might be an early indicator of cardiac involvement in this patient population.