Moysidis Dimitrios V, Papazoglou Andreas S, Tsagkaris Christos, Oikonomou Vasileios, Loudovikou Anna, Kartas Anastasios, Stalikas Nikolaos, Karagiannidis Efstratios, Găman Mihnea-Alexandru, Papadakis Marios, Christodoulaki Chrysi, Panagopoulos Periklis
Faculty of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
Public Health and Policy Working Group, Stg European Student Think Tank, Postjeskade 29, 1058 DE Amsterdam, The Netherlands.
Eur J Investig Health Psychol Educ. 2022 Jul 13;12(7):802-813. doi: 10.3390/ejihpe12070059.
Background: Polycystic ovary syndrome (PCOS) is closely related to various adverse cardiovascular manifestations and increased cardiovascular risk. However, atrial fibrillation (AF) development and atrial conduction abnormalities have not been thoroughly studied in patients with PCOS. Methods: This meta-analysis (CRD42021261375) was conducted in accordance with the PRISMA guidelines. Our aim was to investigate associations between PCOS and disorders in atrial conduction parameters linked with an increased risk for AF occurrence. Results: Five cohort studies with aggregate data on 406 adult women (229 with PCOS and 177 age-matched without PCOS) were included in this analysis. Our results showed a significantly increased mean difference in P-wave maximum duration (+7.63 ± 7.07 msec; p < 0.01) and P-wave dispersion (+11.42 ± 5.22 msec; p = 0.03) of patients with PCOS compared to healthy women. The mean difference in P-wave minimum duration (−2.22 ± 2.68 msec; p = 0.11) did not reach the statistical threshold between the compared groups. Echocardiographic measurements of atrial electromechanical delay (AED) also indicated a statistically significant mean difference in favour of the PCOS group in all assessed parameters, except for atrial electromechanical coupling (PA) in the tricuspid annulus. Particularly, PCOS was associated with increased lateral PA, septal PA, inter- and intra-AED durations (mean difference: +17.31 ± 9.02 msec; p < 0.01, +11.63 ± 7.42 msec; p < 0.01, +15.31 ± 9.18 msec; p < 0.01, +9.31 ± 6.85 msec; p < 0.01, respectively). Conclusions: PCOS is strongly associated with alterations in several electrocardiographic and echocardiographic parameters indicating abnormal atrial conduction. Therefore, PCOS could be considered as a causal or triggering factor of AF. Larger studies are needed to confirm these results and investigate direct associations between PCOS and AF.
多囊卵巢综合征（PCOS）与多种不良心血管表现及心血管风险增加密切相关。然而，PCOS患者的房颤（AF）发生情况及心房传导异常尚未得到充分研究。方法：本荟萃分析（CRD42021261375）按照PRISMA指南进行。我们的目的是研究PCOS与与AF发生风险增加相关的心房传导参数紊乱之间的关联。结果：本分析纳入了五项队列研究，汇总数据涉及406名成年女性（229名患有PCOS，177名年龄匹配的未患PCOS者）。我们的结果显示，与健康女性相比，PCOS患者的P波最大时限（+7.63±7.07毫秒；p<0.01）和P波离散度（+11.42±5.22毫秒；p = 0.03）的平均差异显著增加。P波最小时限的平均差异（−2.22±2.68毫秒；p = 0.11）在比较组之间未达到统计学阈值。心房机电延迟（AED）的超声心动图测量也表明，除三尖瓣环处的心房机电耦联（PA）外，在所有评估参数中，PCOS组均存在统计学上显著的平均差异。特别是，PCOS与外侧PA、间隔PA、心房内外AED持续时间增加相关（平均差异分别为：+17.31±9.02毫秒；p<0.01，+11.63±7.42毫秒；p<0.01，+15.31±9.18毫秒；p<0.01，+9.31±6.85毫秒；p<0.01）。结论：PCOS与多项心电图和超声心动图参数改变密切相关，提示心房传导异常。因此，PCOS可被视为AF的一个因果或触发因素。需要更大规模的研究来证实这些结果，并调查PCOS与AF之间的直接关联。
