CARDIAC FLOW VELOCITY IN WOMEN WITH THE POLYCYSTIC-OVARY-SYNDROME

OBJECTIVE Women with the polycystic ovary syndrome (PCOS) often have s everal of the known risk factors for cardiovascular disease, including hyperinsulinaemia. We have therefore investigated variables of cardia c flow in young women with PCOS and related them to blood levels of re productive hormones (LH, FSH, oestradiol and testosterone) and also of insulin. DESIGN A prospective study. PATIENTS Twenty-six young women with PCOS (mean age 22.8 +/- 0.9 years; mean BMI 23.0 +/- 0.8) and 11 healthy age matched women with regular ovulatory cycles (mean age 26.3 +/- 1.7 years; mean BMI 22.9 +/- 0.9). MEASUREMENTS Cardiac flow was measured by pulsed wave Doppler echocardiography in the follicular pha se of the cycle in controls and oligomenorrhoeic women; there was no s pecial timing for amenorrhoeic women. The indicators assessed were: ej ection fraction (EF), preejection time (PEP), ejection time (ET), peak systolic flow velocity (PFV), acceleration time (AT), flow velocity i ntegral (FVI), mean acceleration (MA), diastolic time (CT), early dias tolic filling time (Ei), atrial filling time interval (Ai), peak veloc ity of the early diastolic filling (PE) and peak velocity of the atria l filling (PA). Serum LH, FSH, oestradiol, testosterone, SHBG and insu lin concentrations were analysed by standard RIA, RESULTS Significantl y lower PFV (1.055 +/- 0.025 vs 1.242 +/- 0.054, P = 0.0006) and MA (1 7.06 +/- 0.57 vs 23.00 +/- 1.49, P = 0.0001) and longer AT (0.063 +/- 0.001 vs 0.056 +/- 0.004, P = 0.026) were found in women with PCOS as compared to age matched controls. Significant negative correlation bet ween serum fasting insulin concentration and EF (r = -0.725, P = 0.002 ), PFV (r = -0.719, P = 0.0025), FVI (r = -0.654, P = 0.008) and MA (r = -0.757, P = 0.001) was observed in the 15 women with PCOS in whom i nsulin was measured, CONCLUSION An inverse relation between serum fast ing insulin level and left ventricular systolic outflow parameters sug gests that insulin is associated with the decreased systolic flow velo city observed in women with PCOS.