Subclinical left ventricular dysfunction in women with polycystic ovary syndrome: an observational study

Erdoğan, Ercan; Akkaya, Mehmet; Bacaksız, Ahmet; Taşal, Abdurrahman; Turfan, Murat; Kul, Şeref; Sönmez, Osman; Vatankulu, Mehmet Akıf; Ertaş, Gökhan; Batmaz, Gonca; Ergelen, Mehmet; Uyarel, Hüseyin; Göktekín, Ömer

doi:10.5152/akd.2013.196

Cited by 5 publications

(5 citation statements)

References 37 publications

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“…In a study of overweight PCOS patients, longitudinal strain measurements were lower than the control group (17). The same study found higher HOMA-IR and insulin levels in PCOS group than the control group, yet the percentage of insulin resistant participants was not mentioned (17). Although the PCOS patients' insulin, HOMA-IR and BMI values were higher than the control group in our study, we did not find any impairment of the left ventricular function in both groups.…”

Section: Discussioncontrasting

confidence: 49%

“…In our study, only 31% of PCOS patients had insulin resistance and this low percentage of insulin resistant patients can possibly explain the similarity between the PCOS and control groups strain measurements. Our mitral inflow and mitral velocity results used for measuring left ventricular diastolic functions revealed no differences between both groups as in Tekin's study (13), yet in Erdogan et al study mitral velocities were lower in PCOS patients (17). In another study, myocardial peak systolic strain, peak early diastolic strain, and peak early diastolic velocity measurements were found to be lower in obese (BMI>30), insulin resistant PCOS patients (18).…”

Section: Discussionmentioning

confidence: 72%

“…This can be explained by the small number of insulin resistant PCOS patients [8 (31%)] in our study. In a study of overweight PCOS patients, longitudinal strain measurements were lower than the control group (17). The same study found higher HOMA-IR and insulin levels in PCOS group than the control group, yet the percentage of insulin resistant participants was not mentioned (17).…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of Polycystic Ovary Syndrome Patients with Strain Echocardiography

Aslan¹,

Aslan²,

Sade³

et al. 2015

IJWHR

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IntroductionPolycystic Ovary Syndrome (PCOS) is a disorder of the reproductive system and is seen in 5 to 10% of the women in reproductive ages (1). Its main features are hyperandrogenism both clinical or biochemical and/or chronic oligo-anovulation and/or ultrasonographic appearance of the polycystic ovaries (2). There are many studies showing the relationship between PCOS and Cardiovascular Diseases (CVD). Insulin resistance, obesity, hypertension, hyperlipidemia, hypercoagulability, and endothelial dysfunction can be seen frequently in PCOS patients along with increased cardiovascular risks (3). Previously published data show that coronary atherosclerosis and increased carotid intima-media thickness can be observed in PCOS (4). The aim of our study was to determine the effects of metabolic factors on myocardial functions in PCOS patients, by measuring the strain (S) and strain rate (SR) as means of quantification of myocardial functions, which were first described by Heimdal et al. to define the global and regional myocardial dysfunction (5), and to identify the possible subclinical impairment of left ventricular myocardial function because of the metabolic components of PCOS. Materials and Methods Study populationThis study was carried out with 26 PCOS patients referred to the Obstetrics and Gynecology Clinic of Baskent University Hospital between December 2008 and September 2009 and 23 healthy female volunteers as control group. The PCOS patients were diagnosed in accordance with 2003 Rotterdam criteria (2). There were neither menstrual cycle abnormalities nor hyperandrogenism in the control group both clinically and biochemically. Clinical symptoms of hyperandrogenism were acne and/or hirsutism. A score higher than 7 based on the modified Ferriman-Gallwey Scale was noted as hirsutism. Any disease other than PCOS including hypertension, diabetes, thyroid function abnormalities, Cushing syndrome, asthma, and other auto-immune diseases, and all medical conditions which caused regular drug use were exclusion criteria for our study. All participants signed the informed consent before enrolling in our study. A physical examination with a detailed anamnesis including body weight and height were performed in all participants. Body Mass Index (BMI) was determined as body weight (kilograms) divided by height (meters) squared. AbstractObjectives: Polycystic Ovary Syndrome (PCOS) is characterized by several metabolic abnormalities that may lead to insulin resistance, diabetes, and atherosclerosis which are associated with chronic inflammatory processes and oxidative stress. Due to this fact PCOS patients are at increased risk of cardiovascular diseases. We used echocardiographic quantification tools to detect subclinical changes in myocardial functions. Materials and Methods:Echocardiographic, hormonal and metabolic measurements were performed in twenty-six women with PCOS and twenty-three healthy volunteers. The age of the attendants ranged between 20 and 31 years. PCOS was diagnosed by using the Rotterdam criteria. ...

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Section: Discussioncontrasting

confidence: 49%

Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

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Evaluation of Polycystic Ovary Syndrome Patients with Strain Echocardiography

Aslan¹,

Aslan²,

Sade³

et al. 2015

IJWHR

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“…Previous studies have indicated that 2D STE is more sensitive than conventional echocardiography for detecting subclinical ventricular dysfunction in various clinical disorders [25,26]. Erdogan et al [27] reported that the GLS values decreased considerably in PCOS patients. We also identified significant decreases in systolic function parameters such as GLS, LS-4C, LS-3C, SRS-4C, SRS-3C, SRS-2C, and GLSRS using STE in PCOS patients compared to the control group; this indicated that subclinical LV dysfunction starts early in PCOS patients.…”

Section: Discussionmentioning

confidence: 99%

The importance of speckle tracking echocardiography in the early detection of left ventricular dysfunction in patients with polycystic ovary syndrome

Demirelli¹,

Değirmenci²,

Ermis³

et al. 2015

Biomol Biomed

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Polycystic ovary syndrome (PCOS) is characterized by hormonal and metabolic abnormalities and is thought to increase a risk for cardiovascular diseases. In this study we use speckle tracking echocardiography (STE) to evaluate left ventricular (LV) dysfunction in the early period of the disease. We enrolled 31 patients with PCOS and 32 healthy volunteers as a control group. The participants' ages ranged between 18 and 40 years. PCOS was diagnosed according to the Rotterdam criteria. LV strain (LS) and strain rate (SR) were evaluated using apical two-chamber (2C), three-chamber (3C), and four-chamber (4C) imaging. Global LS and SR were calculated as average of three apical views. The waist-to-hip ratio, homeostasis model assessment-insulin resistance (HOMA-IR), and fasting insulin and triglyceride levels were higher in the PCOS group than in the controls (p = 0.001, p = 0.001, p = 0.001, and p = 0.005, respectively). In the PCOS group, the mitral A wave, deceleration time (DT), and isovolumetric relaxation time (IVRT) were significantly higher than in the controls (all p < 0.05). The LV global longitudinal strain (GLS) and global longitudinal SR systolic (GLSRS) were significantly lower in the PCOS patient group (both p = 0.001). There were strong negative correlations between GLS and both fasting insulin (r = −0.64) and DT (r = -0.62) (both p < 0.05). The study demonstrated that PCOS patients had decreased LV function using STE. Therefore, STE imaging appears to be useful for the early detection of subclinical LV dysfunction in patients with PCOS.

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“…The recent development of two-dimensional speckle tracking echocardiography (2-D-STE) provides a method for the non-invasive assessment of global and local LV function from two-dimensional (2-D) images ( 10 , 11 ). Previous studies have indicated that 2-D-STE is more sensitive than conventional echocardiography parameters for detecting subclinical ventricular dysfunction in various clinical disorders ( 11 - 13 ).…”

Section: Introductionmentioning

confidence: 99%

Assessment of the left ventricular systolic function in cardiac syndrome X using speckle tracking echocardiography

Yağmur¹,

Açıkgöz²,

Cansel³

et al. 2015

Anatol J Cardiol

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Objective:The aim of this study was to evaluate left ventricular (LV) systolic strain by speckle tracking echocardiography (STE) and real-time three-dimensional echocardiography (3-DE) for the early detection of myocardial dysfunction in patients with cardiac syndrome X (CSX).Methods:We compared 34 patients with CSX (18 females, mean age 47.9±10.0 years) with 41 healthy persons as a control group (23 females, mean age 50.6±9.9 years). Inclusion criteria for CSX were typical angina, a positive exercise ECG stress test, and angiographically documented normal coronary arteries. Exclusion criteria for both groups were hypertension, valvular heart disease, cardiomyopathies, inflammatory diseases, myocarditis, vasculitis, arthropathies, Tietze's syndrome, gastrointestinal diseases, aortic diseases, hormone replacement therapy, arrhythmias, liver diseases, and alcohol use. All subjects underwent two-dimensional STE and 3-DE to assess resting LV function. STE measures were taken from the basal septum, mid-septum, apical septum, apex, apicolateral, mid-lateral, basal lateral, anteroseptal, anterior, anterolateral, inferolateral, inferior, and inferoseptal walls. Student's t-test, Mann–Whitney U test, and chi-square test were used to statistically analyze data.Results:LV echo ejection fraction (EF) and systolic wave peak velocity were similar for both groups. Regional mean longitudinal strain (-17.7±2.5% vs. -19.8±1.8%; p<0.0001) was significantly lower in patients with CSX than in healthy control patients. However, regional mean circumferential strain values (-22.0±1.6% vs. -22.2±2.3%; p=0.78) did not differ significantly between the two groups.Conclusion:Significant impairment of LV longitudinal myocardial systolic function was detected with STE in patients with CSX, although normal 3-D EF and tissue Doppler imaging systolic parameters were observed. Arteriosclerosis of small coronary arteries and microvascular dysfunction may affect myocardial longitudinal strain.

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Subclinical left ventricular dysfunction in women with polycystic ovary syndrome: an observational study

Cited by 5 publications

References 37 publications

Evaluation of Polycystic Ovary Syndrome Patients with Strain Echocardiography

Evaluation of Polycystic Ovary Syndrome Patients with Strain Echocardiography

The importance of speckle tracking echocardiography in the early detection of left ventricular dysfunction in patients with polycystic ovary syndrome

Assessment of the left ventricular systolic function in cardiac syndrome X using speckle tracking echocardiography

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