Zayıf PKOS'lukadınlarda sol ventrikül fonksiyon bozukluğu:speckle tracking ekokardiyografi ileelde edilen bulgular

Year 2024, , 214 - 218, 29.08.2024

Atilla Karateke , Mustafa Kurt , Recep Dokuyucu

https://doi.org/10.47582/jompac.1515967

Abstract

Amaç: Bu çalışmada Speckle tracking ekokardiyografisi ile zayıf kadın PKOS hastalarında sol ventrikül fonksiyonunu (LVEF) değerlendirmeyi amaçladık.
Yöntemler: Çalışmaya PKOS tanısı alan 60 hasta ve yaş ve vücut kitle indeksi açısından eşleştirilmiş 30 sağlıklı kontrol dahil edildi. Şeker, insülin, yüksek hassasiyetli C-reaktif protein (hs-CRP) ve lipit düzeylerini ölçmek için sabah açlık kan örnekleri toplandı. Sol ventrikül fonksiyonu (SVF), iki boyutlu benek izleme ekokardiyografi (2D-STE) ve gerçek zamanlı üç boyutlu ekokardiyografi (3D-Echo) kullanılarak değerlendirildi. Global gerginlik, 2D-STE kullanılarak üç standart apikal görünümden değerlendirildi.
Bulgular: PKOS'lu zayıf kadınlarda hs-CRP düzeyleri kontrol grubuna göre anlamlı derecede yüksekti (2,34±1,07 vs. 1,13±0,54; p˂0,01). 2 odacıklı, 4 odalı ve uzun eksen görüntülerdeki en yüksek uzunlamasına gerilim değerleri, kontrol grubuyla karşılaştırıldığında PKOS'lu zayıf kadınlarda daha düşüktü (15,9±1,2 vs. 19,4±1,2; p˂0,01, 17,0±1,1 vs.) 19,2±1,4; p˂0,01, 16,3±1,3 ve 19,2±1,5; Çoklu regresyon modeline göre, global zorlanma bağımsız olarak hs-CRP (β = 0,31, p = 0,04), erken diyastolik mitral içeri akış hızının (E) erken diyastolik anüler hıza oranı (E/E' oranı) ile ilişkilendirilmiştir ( β = 0,33, p = 0,01) ve ejeksiyon fraksiyonu (EF) (β= 0,35, p = 0,01).
Sonuç: Bulgularımız, PKOS'lu zayıf kadınların, sağlıklı kontrollerle karşılaştırıldığında anlamlı derecede yüksek düzeyde yüksek duyarlıklı C-reaktif protein (hs-CRP) sergilediğini ortaya koymaktadır. Ayrıca, çoklu kardiyak görüntülerde en yüksek uzunlamasına gerilim değerleri, PKOS grubunda belirgin şekilde daha düşüktü; bu, sol ventriküler fonksiyonun bozulduğunu gösteriyor. Bu sonuçlar, PKOS'lu zayıf kadınlarda kardiyovasküler sağlığın izlenmesinin önemini vurgulamaktadır, çünkü bu kadınlarda yağsız vücut kitle indeksine rağmen sol ventriküler fonksiyon bozukluğu gelişme riski yüksektir.

Keywords

PKOS, yüksek hassasiyetli C-reaktif protein, ekokardiyografi

Impaired left ventricular function in lean women with PCOS: Insights from speckle tracking echocardiography

Abstract

Aims: We aimed to conduct a study examining left ventricular function (LVEF) in lean women PCOS patients with speckle tracking echocardiography.
Methods: The study included 60 patients diagnosed with PCOS and 30 healthy controls matched for age and body mass index. Morning fasting blood samples were collected to measure levels of glucose, insulin, high-sensitivity C-reactive protein (hs-CRP), and lipids. Left ventricular function (LVF) was evaluated using two-dimensional speckle tracking echocardiography (2D-STE) and real-time three-dimensional echocardiography (3D-Echo). Global strain was assessed from three standard apical views using 2D-STE.
Results: The hs-CRP levels in lean women with PCOS were significantly higher compared to the control group (2.34±1.07 vs. 1.13±0.54; p=0.01). The peak longitudinal strain values in the 2-chamber, 4-chamber, and long-axis views were lower in lean women with PCOS compared to the control group (15.9±1.2 vs. 19.4±1.2; p=0.01, 17.0±1.1 vs. 19.2±1.4; p=0.01, 16.3±1.3 vs. 19.2±1.5; respectively, p=0.01). According to the multiple regression model, global strain was independently associated with hs-CRP (β=0.31, p=0.04), the ratio of early diastolic mitral inflow velocity (E) to early diastolic annular velocity (E/E’ ratio) (β=0.33, p=0.01), and ejection fraction (EF) (β=0.35, p=0.01).
Conclusion: Our findings reveal that lean women with PCOS exhibit significantly higher levels of high-sensitivity C-reactive protein (hs-CRP) compared to healthy controls. Furthermore, the peak longitudinal strain values across multiple cardiac views were notably lower in the PCOS group, suggesting impaired left ventricular function. These results highlight the importance of monitoring cardiovascular health in lean women with PCOS, as they are at an increased risk of developing left ventricular dysfunction despite their lean body mass index.

Keywords

PCOS, high-sensitivity C-reactive protein, echocardiography

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