Bayır Pınar Türker, Güray Ümit, Duyuler Serkan, Demirkan Burcu, Kayaalp Oya, Kanat Selçuk, Güray Yeşim
Türkiye Clinic of Cardiology, Yüksek İhtisas Hospital, Ankara-Turkey.
Anatol J Cardiol. 2016 Feb;16(2):100-5. doi: 10.5152/akd.2015.5735. Epub 2015 Mar 23.
Polycystic ovary syndrome (PCOS) is associated with increased cardiovascular risk, including ischemic stroke. Prolonged atrial electromechanical interval (EMI) is related to increased atrial fibrillation (AF) risk. The aim of the study is to evaluate atrial EMI and electrocardiographic P-wave indices related to increased AF risk in patients with PCOS.
Forty PCOS patients diagnosed on the basis of the Rotterdam criteria and 20 age-matched controls were prospectively included. patients with atrioventricular or intraventricular conduction abnormalities, dysrhythmia or taking antiarrhythmic drugs, atherosclerotic heart disease, cardiomyopathies, valvular lesions, pericardial disease, a history of pulmonary emboli or pulmonary hypertension, and abnormal thyroid function were excluded. Intra and interatrial EMI were measured by tissue Doppler imaging and P-wave dispersion (Pd) was calculated on 12-lead electrocardiography (ECG). The Isovolumetric relaxation time was the interval between the aortic valve closure artifact at the end of the LV outflow envelope and the mitral valve opening artifact at the beginning of the mitral E wave.
Patients with PCOS had significantly higher interatrial [38 (24-65) ms vs. 16 (9-19) ms p<0.001], left-sided intra-atrial (14.8±6.1 vs. 7±1.7 ms, p<0.001), and right-sided intra-atrial (22.3±8.1 vs. 8.6±3.6 ms, p<0.001) EMI compared with the control group. Pd was significantly greater in the PCOS group compared with control group [45 (27-60) ms vs. 30 (26-38) ms, p<0.001]. Echocardiographic parameters of atrial EMI were significantly correlated with body mass index, Pd, and isovolumetric relaxation time in patients with PCOS.
PCOS is associated with prolonged inter- and intra-atrial conduction times, which are related to increased AF risk.
多囊卵巢综合征（PCOS）与心血管疾病风险增加有关，包括缺血性中风。心房电机械间期（EMI）延长与房颤（AF）风险增加有关。本研究旨在评估PCOS患者中与AF风险增加相关的心房EMI和心电图P波指标。
前瞻性纳入40例根据鹿特丹标准诊断的PCOS患者和20例年龄匹配的对照。排除患有房室或室内传导异常、心律失常或正在服用抗心律失常药物、动脉粥样硬化性心脏病、心肌病、瓣膜病变、心包疾病、肺栓塞或肺动脉高压病史以及甲状腺功能异常的患者。通过组织多普勒成像测量心房内和心房间EMI，并在12导联心电图（ECG）上计算P波离散度（Pd）。等容舒张时间是左心室流出道包络末端主动脉瓣关闭伪像与二尖瓣E波开始时二尖瓣开放伪像之间的时间间隔。
与对照组相比，PCOS患者的心房间[38（24 - 65）ms对16（9 - 19）ms，p<0.001]、左侧心房内（14.8±6.1对7±1.7 ms，p<0.001）和右侧心房内（22.3±8.1对8.6±3.6 ms，p<0.001）EMI显著更高。与对照组相比，PCOS组的Pd显著更大[45（27 - 60）ms对30（26 - 38）ms，p<0.001]。PCOS患者心房EMI的超声心动图参数与体重指数、Pd和等容舒张时间显著相关。
PCOS与心房间和心房内传导时间延长有关，这与AF风险增加有关。
