The Relationship Between Presystolic Wave and Subclinical Left Ventricular Dysfunction Assessed by Myocardial Performance Index in Patients With Polycystic Ovary Syndrome

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.