title: Subclinical left ventricular dysfunction in women with polycystic ovary syndrome: an observational study.
abstract: OBJECTIVE
  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 echocardiographic 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 as well as two-dimensional speckle tracking echocardiography (2D-STE) and real-time three-dimensional echocardiography (3D-Echo). Global longitudinal strain (GLS) was calculated from 3 standard apical views using 2D-STE. Student t-test, chi-square test, Pearson's, and Spearman's correlation analysis were used for statistical analysis.
  
  
  RESULTS
  The early mitral inflow deceleration time (DT), isovolumetric relaxation time (IVRT) and E/Em ratio were increased in the PCOS group (p<0.05 for all). Waist-to-hip ratio, fasting insulin, homeostasis model assessment of insulin resistance (HOMA-IR) and low-density lipoprotein (LDL) levels were higher in PCOS group (p<0.05 for all). Significant correlation was observed between DT, IVRT and insulin value, HOMA-IR (p<0.05 for all). On 3D-Echo evaluation, none of the patients in both groups had LV systolic dysfunction with comparable LV ejection fraction 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 (p<0.05 for all).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Cardiology, Faculty of Medicine, Bezmialem Vakıf University, İstanbul-Turkey. drercanerdogan@gmail.com.
authors.forename: Ercan
authors.initials: E
authors.lastname: Erdoğan
authors.forename: Mehmet
authors.initials: M
authors.lastname: Akkaya
authors.forename: Ahmet
authors.initials: A
authors.lastname: Bacaksız
authors.forename: Abdurrahman
authors.initials: A
authors.lastname: Tasal
authors.forename: Murat
authors.initials: M
authors.lastname: Turfan
authors.forename: Seref
authors.initials: S
authors.lastname: Kul
authors.forename: Osman
authors.initials: O
authors.lastname: Sönmez
authors.forename: Mehmet Akif
authors.initials: MA
authors.lastname: Vatankulu
authors.forename: Gökhan
authors.initials: G
authors.lastname: Ertaş
authors.forename: Gonca
authors.initials: G
authors.lastname: Batmaz
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ergelen
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Uyarel
authors.forename: Omer
authors.initials: O
authors.lastname: Göktekin
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D004452:Echocardiography; D019560:Echocardiography, Three-Dimensional; D005260:Female; D006801:Humans; D011085:Polycystic Ovary Syndrome / Q000000981:diagnostic imaging / Q000503:physiopathology*; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology*