Increased Sympathetic Cardiac Autonomic Modulation after Two Consecutive Tilt Tests in Women with Polycystic Ovary Syndrome

Ribeiro, Victor Barbosa; Kogure, Gislaine Satyko; Silva, Rafael Costa; Souza, Hugo Celso Dutra de; Ferriani, Rui Alberto; Reis, Rosana Maria dos

doi:10.1055/s-0040-1701467

Cited by 3 publications

(3 citation statements)

References 34 publications

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“…Similarly, a study by Ribeiro et al reported no significant fat distribution between cases and control [28]. Hyperandrogenism and Insulin resistance may contribute to increased sympathetic tone in PCOS patients rather than BMI [29].…”

Section: Discussionmentioning

confidence: 89%

Assessment of Cardiac Autonomic Function in Women With Polycystic Ovary Syndrome Through Ewing's Battery, Heart Rate Variability Analysis, and Composite Autonomic Symptom Score-31 Scale

Shrivastava,

Pathak,

Shrivastava

et al. 2023

Cureus

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IntroductionPolycystic ovary syndrome (PCOS) is a frequently occurring endocrine condition prevalent in women of reproductive age characterized by chronic anovulation, hyperandrogenism, insulin resistance, and a lowgrade inflammatory state. Patients with PCOS are more vulnerable to developing cardiac and metabolic comorbidities. Sympathetic overactivity is also reported in PCOS patients. ObjectiveThis study aimed to assess cardiac autonomic function in PCOS by Heart Rate Variability Analysis, Ewing's Test, and Composite Autonomic Symptom Scale-31 (COMPASS-31). MethodsThirty female PCOS patients and 30 age-matched control females were enrolled in the study. Both cases and controls were subdivided into sub-groups based on body mass index (BMI) and waist-to-hip ratio (WHR). The cardiac autonomic functions were assessed by the COMPASS-31 questionnaire, Ewing's battery tests, and short-term heart rate variability analysis. ResultsThere was no significant difference in age, BMI, and WHR of both groups. Additionally, cases had a significantly higher low frequency to high frequency (LF/HF) ratio and COMPASS-31 score and also reported more derangement in Ewing's battery test, indicating cardiac autonomic dysfunction in PCOS patients. ConclusionPatients with PCOS are more prone to developing cardiac and metabolic co-morbidities. Early assessment of cardiac autonomic function can prevent future complications with timely interventions. Altered autonomic function in PCOS patients can be due to hyperandrogenism and insulin resistance.

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Section: Discussionmentioning

confidence: 89%

Assessment of Cardiac Autonomic Function in Women With Polycystic Ovary Syndrome Through Ewing's Battery, Heart Rate Variability Analysis, and Composite Autonomic Symptom Score-31 Scale

Shrivastava,

Pathak,

Shrivastava

et al. 2023

Cureus

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“…(5)(6)(7)(8)(9) The Rotterdam criteria (2003), used for diagnosis, require 2 of the 3 aforementioned criteria, being facultative ovarian cysts. (1)(2)(3) Its diagnosis is of exclusion. Pathologies such as ovarian or adrenal tumors, hyperprolactinemia, hypo-or hyperthyroidism and Cushing syndrome can cause the same androgenic and anovulation symptoms and can mask the syndrome.…”

Section: Polycystic Ovary Syndromementioning

confidence: 99%

“…The diagnosis of PCOS is based on the Rotterdam criteria, characterized with hyperandrogenism, chronic anovulation and polycystic ovaries on ultrasound. (3) Excess androgen alters the regulation of female hormones, resulting in menstrual irregularity and infertility. Among its main manifestations are hirsutism, acne, seborrhea, and alopecia.…”

Section: Introductionmentioning

confidence: 99%

Fetal Metabolic Programming in the Etiology of Polycystic Ovarian Syndrome

Silva¹,

Vargas²

2023

Rev. Contemp.

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Polycystic ovary syndrome (PCOS) is an endocrine dysfunction, which can be characterized by hyperandrogenism and chronic anovulation. The main signs of PCOS are amenorrhea and polycystic forms in the ovaries, being the most common disorder in women in menacme and very commonly associated with other metabolic syndromes. Studies suggest that one of the etiological factors of the syndrome is related to fetal metabolic programming, maternal, nutritional, genetic and environmental influences are determinant in the emergence of diseases, including PCOS. The objective of this work is to relate the fetal metabolic programming with the development of PCOS. The study methodology consists in a literature review, through research in PubMed and Scielo databases. It is concluded that factors such as placental pathologies and maternal metabolism, fetal hypoxia, intrauterine growth restriction, low birth weight, maternal hyperandrogenism state and pathologies that corroborate this, hyperinsulinemia, and insulin resistance (IR), in addition to maternal exposure to plastic components, such as bisphenol A, are factors associated with the etiology of PCOS. Thus, during pregnancy, care must be taken to minimize the chances of future adolescents developing the syndrome and the various comorbidities that are associated with it.

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Exploring heart rate variability in polycystic ovary syndrome: implications for cardiovascular health: a systematic review and meta-analysis

Mirzohreh,

Panahi,

Heidari

2024

Syst Rev

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Objectives Polycystic ovary syndrome (PCOS) is a prevalent and complex endocrine disorder that affects women of reproductive age. It has significant implications for female endocrine function, reproductive health, and metabolic disturbances, including insulin resistance, impaired glucose tolerance, and dyslipidemia. Studies have shown that decreased heart rate variability (HRV), a marker of autonomic dysfunction, is associated with adverse cardiovascular events. Recent research has focused on investigating autonomic function in PCOS, and some studies have suggested altered autonomic drive in these patients. The aim of this systematic review and meta-analysis was to evaluate cardiac autonomic function by analyzing HRV in women with PCOS. Methods This systematic review was prepared using PRISMA reporting guidelines. The databases searched were PubMed, Scopus, Web of Science, and Cochrane. Risk of Bias was assessed using ROBINS-I for non-RCTs. The GRADE approach was employed to evaluate the level of certainty in the evidence for each outcome. In order to identify the underlying cause of high heterogeneity, a subgroup analysis was conducted. Sensitivity analysis was checked. A random effect model was used and calculated a pooled standardized mean difference (SMD) with a 95% confidence interval (CI). Results Seventeen articles were included in the final analysis, varied in quality, ranging from a "low" to a "high risk of bias". Combined analyses indicated a notable decrease in HRV among individuals with PCOS compared to the control group. Significant changes were observed in SDNN (SMD: -0.763, 95%CI [-1.289 to -0.237], p=0.004), PNN50 (SMD: -1.245, 95%CI [-2.07, -0.419], p=0.003), LF/HF ratio (SMD: 0.670, 95%CI [0.248, 1.091], p=0.002), HFnu (SMD: -0.873, 95%CI [-1.257, -0.489], p=0.000), LFnu (SMD: 0.840, 95%CI [0.428, 1.251], p=0.000) and TP (SMD: -1.997, 95%CI [-3.306, -0.687], p=0.003). The heterogeneity was partially explained by types of study design. Subgroup analysis revealed significant alterations of HRV in normal-weighted and overweight PCOS cases. Conversely, no significant changes in HRV were observed in obese PCOS cases. Conclusion The findings of this meta-analysis provide evidence suggesting diminished HRV in individuals with PCOS compared to non-PCOS control group.

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Increased Sympathetic Cardiac Autonomic Modulation after Two Consecutive Tilt Tests in Women with Polycystic Ovary Syndrome

Cited by 3 publications

References 34 publications

Assessment of Cardiac Autonomic Function in Women With Polycystic Ovary Syndrome Through Ewing's Battery, Heart Rate Variability Analysis, and Composite Autonomic Symptom Score-31 Scale

Assessment of Cardiac Autonomic Function in Women With Polycystic Ovary Syndrome Through Ewing's Battery, Heart Rate Variability Analysis, and Composite Autonomic Symptom Score-31 Scale

Fetal Metabolic Programming in the Etiology of Polycystic Ovarian Syndrome

Exploring heart rate variability in polycystic ovary syndrome: implications for cardiovascular health: a systematic review and meta-analysis

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