ASSESSMENT OF CARDIOVASCULAR AUTONOMIC REACTIVITY IN PATIENTS WITH POLYCYSTIC OVARY SYNDROME

Abstract

Polycystic ovary syndrome (PCOS) in association with obesity poses a significant cardiovascular risk. Autonomic dysfunction is an early marker of cardiovascul ar risk. The conventional autonomic function tests (CAFT) are standard noninvasive methods of evaluating cardiovascular autonomic re activities. The study was conducted to assess the autonomic reactivity in patients with PCOS using CAFT. Forty newly diagno sed patients with PCOS and 36 age - matched controls were recruited. Body mass index (BMI), waist - hip ratio (WHR), cardiovascular parameters such as basal heart rate (BHR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and rate - pressure product (RPP), were measured in them. CAFT assessed were HR and BP response to standing (30:15 ratio), deep breathing (E:I ratio) and isometric handgrip (ΔDBP ihg ). Association of CAFT reactivity parameters with RPP was assessed by Pearson correlation. Individual association of CAFT reactivity parameters to RPP was assessed by multiple regression analysis. The cases had significantly increased BMI, WHR, BHR, SBP, DBP, MAP and RPP. E:I ratio was decreased and 30:15 ratio and ΔDBP ihg w ere increased in cases. 30:15 ratio and ∆DBP ihg had a significant positive correlation with RPP and E:I ratio showed negative correlation. Multiple regression analysis demonstrated independent association of RPP with E:I ratio and ∆DBP ihg . We conclude tha t PCOS patients have altered autonomic modulation in the form of increased sympathetic and decreased parasympathetic reactivity. The autonomic dysregulation is linked to myocardial performance in PCOS, which could expose PCOS patients to cardiovascular mor bidities.