The Early Detection of Subclinical Left Ventricular Diastolic Dysfunction in Iraqi Women with Polycystic Ovarian Syndrome


ABSTRACT:BACKGROUND: The left ventricular diastolic dysfunction (LVDD) in asymptomatic patients with polycystic ovarian syndrome (PCOS) has been documented by both pulsed wave Doppler and tissue Doppler echocardiography.OBJECTIVE: The aim of this study was to identify the earliest asymptomatic impairment of the left ventricular diastolic dysfunction in polycystic ovarian syndrome women.PATIENTS AND METHODS: This study is conducted by the Department of Physiology, College of Medicine, Al-Mustansiriya University in cooperation with the unit of Infertility and unit of Echocardiography at Al-Yarmook teaching hospital in Baghdad during the period from December 2015 to April 2017. A total number of 150 subjects were included in this study, 50 healthy subjects (control group) and 100 patients with polycystic ovarian syndrome with (mean age and standard deviation of 28.27 ± 7.27 years). Pulsed wave blood flow Doppler and tissue Doppler imaging were used for estimating left ventricular diastolic dysfunction.RESULTS: 11% of the 100 PCOS women showed evidence of left ventricular diastolic dysfunction through impairment of mitral valve annular velocities and in the filling velocities of the left ventricle by pulsed wave Doppler, the ratio of peak early (E) filling velocity to the late (A) filling velocity (E/A ratio) was significantly lower in polycystic ovarian syndrome women with left ventricular diastolic dysfunction (0.780.17). By TDI the ratio of early (e՛) mitral annular velocity to the late (a՛) mitral annular velocity (e՛/a՛ ratio) was significantly reduced in polycystic ovarian syndrome women with the left ventricular diastolic dysfunction. Body mass index, waist circumference, waist-to-hip ratio, fasting blood sugar, fasting insulin, serum cholesterol, serum triglycerides, low density lipoprotein, very low density lipoprotein and homeostasis model assessment of insulin resistance were higher in polycystic ovarian syndrome group with left ventricular diastolic dysfunction.CONCLUSION: Diastolic dysfunction can develop early in patient with PCOS, and might be an early signal for cardiac involvement in this patient population..