Zehir Regayip, Karabay Can Yucel, Kocabay Gonenc, Kalayci Arzu, Kaymaz Ozge, Aykan Ahmet Cagrı, Karabay Emre, Kirma Cevat
Kartal Kosuyolu Heart and Research Hospital, Cardiology Department, Istanbul, Turkey.
J Interv Card Electrophysiol. 2014 Nov;41(2):137-43. doi: 10.1007/s10840-014-9925-8. Epub 2014 Jul 9.
Polycystic ovary syndrome (PCOS) is closely related to increased cardiovascular risk in women of reproductive age. Atrial conduction abnormalities in these patients have not been investigated in terms of atrial electromechanical delay measured by tissue Doppler imaging (TDI) as an early predictor of atrial fibrillation development. The aim of this study was to evaluate whether TDI-derived atrial conduction time is prolonged in PCOS.
The study included 51 patients with PCOS and 48 age-matched healthy controls. P-wave dispersion (PWD) was calculated on the 12-lead surface electrocardiogram. Systolic and diastolic left ventricular (LV) functions, atrial electromechanical coupling, intraatrial and interatrial electromechanical delays were measured with conventional echocardiography and TDI.
PWD was higher in PCOS women (50.45 ± 3.7 vs 34.73 ± 6.7 ms, p = 0.008). Interatrial and intraatrial electromechanical delay were found longer in patients with PCOS compared to controls (41.9 ± 9.0 vs 22.2 ± 6.6 ms, p < 0.001; 22.6 ± 5.8 vs 5.9 ± 4.7 ms, p < 0.001, respectively). Left atrial (LA) volume index and LV diastolic parameters were significantly different between the groups. PWD was correlated with interatrial electromechanical delay (r = 0.54, p < 0.01). Interatrial electromechanical delay was strongly correlated with homeostatic model assessment insulin resistance index and high-sensitivity C-reactive protein levels (r = 0.68, p < 0.001; r = 0.53, p < 0.001, respectively). Interatrial electromechanical delay was positively correlated with LA volume index and deceleration time (r = 0.31, p = 0.04; r = 0.37, p = 0.021, respectively) and negatively correlated with flow propagation velocity (r = -0.38, p = 0.014).
This study shows that atrial electromechanical delay is prolonged in PCOS patients. Atrial electromechanical delay prolongation is related to low-grade inflammation, insulin resistance, and LV diastolic dysfunction in PCOS.
多囊卵巢综合征（PCOS）与育龄期女性心血管风险增加密切相关。尚未根据组织多普勒成像（TDI）测量的心房机电延迟作为心房颤动发展的早期预测指标，对这些患者的心房传导异常进行研究。本研究的目的是评估PCOS患者中TDI衍生的心房传导时间是否延长。
该研究纳入了51例PCOS患者和48例年龄匹配的健康对照者。在12导联体表心电图上计算P波离散度（PWD）。用传统超声心动图和TDI测量左心室（LV）的收缩和舒张功能、心房机电耦合、房内和房间机电延迟。
PCOS女性的PWD更高（50.45±3.7 vs 34.73±6.7 ms，p = 0.008）。与对照组相比，PCOS患者的房间和房内机电延迟更长（分别为41.9±9.0 vs 22.2±6.6 ms，p < 0.001；22.6±5.8 vs 5.9±4.7 ms，p < 0.001）。两组之间左心房（LA）容积指数和LV舒张参数有显著差异。PWD与房间机电延迟相关（r = 0.54，p < 0.01）。房间机电延迟与稳态模型评估胰岛素抵抗指数和高敏C反应蛋白水平密切相关（分别为r = 0.68，p < 0.001；r = 0.53，p < 0.001）。房间机电延迟与LA容积指数和减速时间呈正相关（分别为r = 0.31，p = 0.04；r = 0.37，p = 0.021），与血流传播速度呈负相关（r = -0.38，p = 0.014）。
本研究表明PCOS患者的心房机电延迟延长。心房机电延迟延长与PCOS中的低度炎症、胰岛素抵抗和LV舒张功能障碍有关。
