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多囊卵巢综合征患者收缩前期波与心肌做功指数评估的亚临床左心室功能障碍的关系。

The relationship between presystolic wave and subclinical left ventricular dysfunction assessed by myocardial performance ındex in patients with polycystic ovary syndrome.

机构信息

Department of Cardiology, Van Education and Research Hospital, Van, Turkey.

出版信息

Echocardiography. 2021 Sep;38(9):1534-1542. doi: 10.1111/echo.15166. Epub 2021 Jul 22.

DOI:10.1111/echo.15166
PMID:34296457
Abstract

BACKGROUND

Polycystic ovary syndrome (PCOS) patients have left ventricular dysfunction (LVD) in an earlier stage. Myocardial performance index (MPI) reflects both systolic and diastolic dysfunction. A presystolic wave (PSW) detected on late diastole has been found to be associated with LVD.

AIMS

We sought to determine whether there is an association between PSW and subclinical LVD assessed by MPI in PCOS patients.

METHODS

We prospectively enrolled 106 patients diagnosed with PCOS in this study. Patients were divided into two groups based on the presence of PSW. Both groups were compared with respect to demographic, clinical, and echocardiographic properties. Univariable and multivariable regression analyses were performed to detect predictors of subclinical LVD.

RESULTS

The study included 58 patients with PSW-positive (54.7%, mean age: 23) and 48 patients with PSW-negative (45.3%, mean age: 25). PSW-positive patients had a higher waist-to-hip ratio, fasting insulin, and HOMA-IR compared to PSW-negative patients. Higher MPI velocities and more frequent subclinical LVD were observed in PSW-positive group than in PSW-negatives (p < 0.001, p = 0.0031, respectively). PSW velocity was significantly correlated with MPI velocity (r:.404, p = 0.0016). The presence of PSW, HOMA-IR, and waist-to-hip ratio > 85 were predictors of subclinical LVD in univariate logistic regression analysis. Only the presence of PSW was an independent predictor of subclinical LVD in multivariable logistic regression analysis (OR:3.257, p = 0.028).

CONCLUSION

PSW prevalence was 54.7% in PCOS patients. PSW velocity was significantly correlated with MPI velocity. The presence of PSW was independently associated with subclinical LVD in PCOS women.

摘要

背景

多囊卵巢综合征(PCOS)患者在早期就存在左心室功能障碍(LVD)。心肌做功指数(MPI)反映了收缩和舒张功能障碍。在舒张晚期检测到的收缩前期波(PSW)已被发现与 LVD 相关。

目的

我们旨在确定 PCOS 患者中 PSW 与 MPI 评估的亚临床 LVD 是否存在关联。

方法

我们前瞻性地纳入了本研究中诊断为 PCOS 的 106 例患者。根据 PSW 的存在,将患者分为两组。比较两组的人口统计学、临床和超声心动图特征。进行单变量和多变量回归分析,以检测亚临床 LVD 的预测因素。

结果

该研究包括 58 例 PSW 阳性(54.7%,平均年龄:23 岁)和 48 例 PSW 阴性(45.3%,平均年龄:25 岁)患者。PSW 阳性患者的腰围-臀围比、空腹胰岛素和 HOMA-IR 高于 PSW 阴性患者。与 PSW 阴性患者相比,PSW 阳性组的 MPI 速度更高,亚临床 LVD 更常见(p<0.001,p=0.0031)。PSW 速度与 MPI 速度显著相关(r:.404,p=0.0016)。在单变量逻辑回归分析中,PSW 的存在、HOMA-IR 和腰围-臀围比>85 是亚临床 LVD 的预测因素。仅 PSW 的存在是多变量逻辑回归分析中亚临床 LVD 的独立预测因素(OR:3.257,p=0.028)。

结论

在 PCOS 患者中,PSW 的患病率为 54.7%。PSW 速度与 MPI 速度显著相关。PSW 的存在与 PCOS 女性的亚临床 LVD 独立相关。

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