Echocardiography Measurements in Echocardiography Measurements in Obese and Non-Obese Polycystic Ovarian Syndrome Women Ismail Ibrahim Hussain* PhD, Henan Dh. Skheel** FICMS, Suaad Muhssen Ghazi* MSc
Background: Obesity andpretem lab insulin resistance (IR) may produce disorder of left ventricular (LV) function, obese polycystic ovarian syndrome (PCOS) women have many hormonal and metabolic abnormalities are thought to be increased cardiovascular risk.
Objectives: To explore the role of obesity and IR in the pathogenesis of early structural functional changes in echocardiographic parameters associated with PCOS.
Methods: The study was conducted at Department of Physiology, Medical College of AlMustansiriya University in cooperation with the unit of Infertility and echocardiography at Al-Yarmook teaching hospital in Baghdad during the period from December 2015 to March 2017. One hundred Iraqi women with PCOS (aged 16 to 45 years) were included in this study. The clinical and metabolic characteristics were done for all patients [body mass index (BMI), waist circumference, waist to hip ratio (WHR), FBS, fasting insulin, lipid profile and homeostasis model assessment of insulin resistance (HOMA-IR)]. Echocardiographic measurements both Pulsed-wave Doppler and tissue Doppler imaging (TDI) were done for all patients.
Results: One hundred women with PCOS were divided into two groups according to BMI ˂ 30 kg/m2 as not obese with 46% and ˃ 30 kg/m2 regarding as obese PCOS woman with 54%. And when we compared between two groups in clinical and metabolic characteristics, there were significant differences between two groups in BMI, waist circumference, WHR, fasting insulin, serum cholesterol, low density lipoprotein (LDL), very low density lipoprotein (VLDL), low density lipoprotein/high density lipoprotein ratio (LDL/HDL) and HOMA-IR, were all higher in obese PCOS women. Echocardiographic measurement both (Conventional) pulsed-wave Doppler and TDI done for both groups and there were significant differences between obese and non-obese women with PCOS in peak early filling velocity (E), E/A ratio, lateral e՛, lateral e՛/a՛ ratio, medial a՛, medial e՛/a՛, e՛ average, were all lower in obese PCOS women, while a՛ average, deceleration time (DT), left ventricular end diastolic dimension (LVEDD), left ventricular end systolic dimension (LVESD) and interventricular septum thickness (IVS) were slightly higher in obese PCOS women. One patient with PCOS with BMI ˂ 30 kg/m2 has left ventricular diastolic dysfunction (LVDD) and ten women with PCOS with BMI ˃ 30 kg/m2 have LVDD as early asymptomatic subclinical LVDD diagnosed by both TDI and pulsed-wave Doppler.
Conclusion: PCOS women who have asymptomatic LVDD tend to be more obese by increased BMI, wider waist circumference and high waist to hip ratio and have high insulin level and HOMA-IR. Given the pivotal role to obesity and insulin resistance were play in the etiopathogenesis and progression of PCOS and its potential subsequent metabolic and cardiovascular complications.
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