De Jong Kirstie A, Berisha Filip, Naderpoor Negar, Appelbe Alan, Kotowicz Mark A, Cukier Kimberly, McGee Sean L, Nikolaev Viacheslav O
Institute of Experimental Cardiovascular Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
DZHK (German Center for Cardiovascular Research), partner site Hamburg/Kiel/Lübeck, Germany.
PLoS One. 2022 Feb 25;17(2):e0263312. doi: 10.1371/journal.pone.0263312. eCollection 2022.
It remains unclear as to whether polycystic ovary syndrome (PCOS) is an additional risk factor in the development of left ventricular (LV) hypertrophy in obese women. In the current study, we provide clarity on this issue by rigorously analysing patient LV geometry beyond the basic clinical measures currently used. Importantly, the cohort contained only normotensive patients that would normally be deemed low risk with no further intervention required.
The study comprised 24 obese women with PCOS and 29 obese Control women. Transthoracic echocardiography was used to evaluate LV structure/function. Basic clinical and metabolic data were collected for each participant consisting of age, BMI, blood pressure, fasting glucose, LDL-C, HLD-C, cholesterol and triglyceride levels. Exclusion criteria; BMI < 30 g/m2, type 2 diabetes, hypertension.
Both groups exhibited concentric remodelling of the LV posterior wall at a prevalence of ~20%, this associated with grade 1 diastolic dysfunction. Estimated LV mass/height2.7 was increased patients with PCOS (45 ± 2.2 vs 37 ± 1.6) with 33% exhibiting LV mass/height2.7 above ASE guidelines, compared to 7% in Controls. Furthermore, 25% of patients with PCOS were characterised with concentric hypertrophy, an alteration in LV geometry that was not observed in the Control group.
To our knowledge, this is the first study to assess LV geometric patterns in obese women with PCOS. The results suggest that obese women with PCOS are at greater risk of concentric hypertrophy than obese only women and provide justification for additional cardiovascular risk assessment in normotensive obese/PCOS women.
多囊卵巢综合征(PCOS)是否为肥胖女性左心室(LV)肥厚发展的额外危险因素仍不明确。在本研究中,我们通过严格分析目前使用的基本临床指标以外的患者左心室几何形态,来阐明这一问题。重要的是,该队列仅包含通常被认为低风险且无需进一步干预的血压正常患者。
本研究纳入了24名患有PCOS的肥胖女性和29名肥胖对照女性。采用经胸超声心动图评估左心室结构/功能。收集每位参与者的基本临床和代谢数据,包括年龄、体重指数、血压、空腹血糖、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、胆固醇和甘油三酯水平。排除标准:体重指数<30g/m2、2型糖尿病、高血压。
两组均表现出左心室后壁向心性重塑,患病率约为20%,这与1级舒张功能障碍相关。PCOS患者的左心室质量/身高2.7估计值增加(45±2.2 vs 37±1.6),33%的患者左心室质量/身高2.7高于美国超声心动图学会(ASE)指南,而对照组为7%。此外,25%的PCOS患者表现为向心性肥厚,这是对照组未观察到的左心室几何形态改变。
据我们所知,这是第一项评估患有PCOS的肥胖女性左心室几何形态模式的研究。结果表明,患有PCOS的肥胖女性比仅肥胖女性发生向心性肥厚的风险更高,并为血压正常的肥胖/PCOS女性进行额外的心血管风险评估提供了依据。