ABSTRACT
Polycystic Ovary Syndrome [PCOS] is considered not only a reproductive endocrinopathy but also a metabolic disorder associated with long term health risks, including diabetes mellitus and coronary artery disease and it shares some or all components of syndrome X. To assess and evaluate cardiovascular risk factors in patients with PCOS and to compare the various systolic and diastolic function indices hetween PCOS patients and regularly cycling control women. 45 patients with PCOS [mean age 26.16 +/- 6.47 years and mean BMI 28.18"5.47 kg/m[2]] were recruited for this study, in addition to 30 healthy volunteer women with regular menstrual cycles, their age and body mass index [BMI] matched with the patients group. A thorough history and clinical examination were performed. Transvaginal sonography was performed using a transvaginal probe 5 MHZ. Hormonal assay for [serum luteinizing hormone [LH], follicle stimulating hormone [FSH], prolactin and total testosteronel, lipid profile [high and low density lipoproteins [HDL and LDL], triglyceride [TG] and total cholesterol [T Chol]], uric acid, homocysteine and two hours post prandial serum glucose [PPSG] levels were determined for all studied participants. M-mode, two dimension and Doppler echocardiography were performed for evaluation of systolic and diastolic function parameters. We have studied indices of cardiac flow in women with PCOS in relation to BMI, blood levels of reproductive hormones [LH, FSH. testosterone and prolactin]. lipid profile, uric acid, PPSG and homocsteine levels. The mean serum levels of LH, total testosterone, T Chol, TG, homocysteine, uric acid, PPSG, LH/FSH ratio and T Chol./HDL ratio were significantly higher in patients with PCOS group [p <0.001] than control group. Patients with PCOS had significantly lower peak mitral flow velocity in early diastole [PEV], ratio between peak mitral flow velocity in early diastole [E] and late diastole [A] [B/A ratio], Ejection fraction [EF] and fraction of shortening [FS] [p < 0.001] and significantly longer isovolumic relaxation time [IVRT] and E-velocity deceleration time [EVDT] [p <0.001]. Patients with PPSG> 140 mg/dl had significantly lower B/A ratio [p < 0.05] and those with BMI > 25 kg/m[2] had significantly longer IVRT [p <0.01]. Moreover, we found significant negative correlation between E/A ratio and both PPSG [r = -0.349] and LDL [r = -0.382] and significant positive correlation between IVRT and BMI [r = 0.415]. We conclude that both diastolic and systolic dysfunction are common findings in population with PCOS and this dysfunction together with the increased serum homocysteine concentration, dyslipidemia and impaired glucose tolerance may contribute to increased risk of cardiovascular disease in these patients