Polikistik Over Sendromunda Subklinik Ventriküler Disfonksiyonun Ekokardiyografik Değerlendirmesi: İzovolümik Hızlanma ve Miyokardiyal Performans İndeksinin Rolü

Abstract

Amaç: Polikistik over sendromu (PKOS), artmış kardiyovasküler risk ve potansiyel subklinik ventriküler disfonksiyon ile ilişkili yaygın bir endokrin bozukluktur. İzovolümik ivme (IVA), miyokardiyal kontraktiliteye duyarlı ve ön yük ve son yükten daha az etkilenen yeni nesil ekokardiyografik parametredir ve kardiyak disfonksiyonun erken tespiti için umut vermektedir. Bu çalışma, PKOS hastalarında subklinik ventriküler disfonksiyonu belirlemede IVA ve diğer ekokardiyografik parametrelerin etkinliğini değerlendirmeyi amaçlamaktadır. Metod: 59 PKOS hastası ile vücut kütle indeksleri (VKI) benzer 60 kontrol hastasının dahil olduğu kesitsel bir çalışmadır. IVA, miyokardiyal performans indeksi (MPİ) ve diğer konvansiyonel ekokardiyografik veriler değerlendirildi. Bulgular: PKOS hastalarında, kontrol grubuna oranla daha VKI ve açlık glikoz seviyesi (p<0,001) izlendi. PCOS grubunda sol ventrikül MPI' si daha yüksek bulundu (0,56 ± 0,11'e karşı 0,46 ± 0,07, p=0,004). PCOS hastalarında sağ ventrikül IVA anlamlı ölçüde düşüktü (2,77 ± 0,69'a karşı 3,98 ± 1,01, p=0,030), triküspit hızlanma süresi ise uzamıştı (p<0,001). PCOS grubunda IVA ile MPI arasında pozitif bir korelasyon gözlendi (R=0,453, p<0,001). Çok değişkenli analiz PCOS' u subklinik sol ventrikül disfonksiyonunun bağımsız bir öngörücüsü olarak tanımladı (OR=0,211, p<0,001). Sonuç: PCOS, özellikle IVA ile tespit edilen sağ ventrikül sistolik fonksiyonunu etkileyen kardiyak fonksiyonda hafif değişikliklerle ilişkilidir. Bu bulgular, IVA'nın PCOS hastalarında erken kardiyovasküler risk değerlendirmesi için invaziv olmayan bir belirteç olarak potansiyelini vurgulayarak, bu popülasyonda düzenli kardiyak izlemenin önemini vurgulamaktadır.

Keywords

• Polikistik Over Sendromu
• Doku kaynaklı doppler
• İzovolümik Hızlanma
• Miyokardiyal Performans İndeksi
• Subklinik Ventriküler Disfonksiyon

Echocardiographic evaluation of subclinical ventricular dysfunction in polycystic ovary syndrome: the role of isovolumic acceleration and myocardial performance index

Abstract

Aims: Polycystic ovary syndrome (PCOS) is a common endocrine disorder associated with increased cardiovascular risk and potential subclinical ventricular dysfunction. Isovolumic acceleration (IVA) is a novel echocardiographic parameter sensitive to myocardial contractility and less influenced by preload and afterload, making it a promising tool for early detection of cardiac dysfunction. This study aimed to assess the utility of IVA and other echocardiographic markers in identifying subclinical ventricular dysfunction in PCOS patients. Methods: This cross-sectional study analyzed echocardiographic parameters of 59 PCOS patients and 60 age-and BMI-matched controls. Echocardiographic measurements included IVA, myocardial performance index (MPI), and additional indices of right and left ventricular function. Results: PCOS patients exhibited significantly higher BMI and fasting glucose levels (p<0.001) than controls. Left ventricular MPI was elevated in the PCOS group (0.56±0.11 vs. 0.46±0.07, p=0.004). Right ventricular IVA was significantly lower in PCOS patients (2.77±0.69 vs. 3.98±1.01, p=0.030), while tricuspid acceleration time was prolonged (p<0.001). A positive correlation between IVA and MPI was observed in the PCOS group (R=0.453, p<0.001). Multivariate analysis identified PCOS as an independent predictor of subclinical left ventricular dysfunction (OR=0.211, p<0.001). Conclusion: PCOS is associated with subtle alterations in cardiac function, particularly affecting right ventricular systolic function as detected by IVA. These findings highlight IVA's potential as a non-invasive marker for early cardiovascular risk assessment in PCOS patients, emphasizing the importance of regular cardiac monitoring in this population.

Keywords

• Polycystic ovary syndrome
• tissue derived Doppler
• isovolumic acceleration
• myocardial performance index
• subclinical ventricular dysfunction

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