Diastolic dysfunction and increased serum homocysteine concentrations may contribute to increased cardiovascular risk in patients with polycystic ovary syndrome

Objective: To assess cardiac flow parameters in patients with polycystic ov ary syndrome (PCOS). Design: A prospective case-control study. Setting: University-based hospital. Patient(s): Thirty consecutive patients with PCOS were enrolled. Thirty wom en with regular menstrual cycles served as the controls. Intervention(s): Systolic and diastolic function parameters were assessed b y standard two-dimensional and M-mode echocardiography. Insulin sensitivity was evaluated by a standard 75-g oral glucose tolerance test and area-unde r-curve insulin analysis. Serum hormones, lipid profile, homocysteine, vita min B-12, folate, fibrinogen, uric acid, and plasminogen activator inhibito r-I concentrations were measured. Main Outcome Measure(s): Systolic and diastolic function parameters, insuli n sensitivity and serum homocysteine levels. Result(s): The mean serum homocysteine and uric acid concentrations were si gnificantly higher in the PCOS Group. Patients with PCOS had significant hy perinsulinemia. All systolic function parameters were comparable between th e two groups. However, patients with PCOS had significantly lower peak mitr al flow velocity in early diastole and significantly lower ratio between th e early and late peak mitral flow velocities and also had significantly lon ger isovolumic relaxation time, reflecting a trend for nonrestrictive-type diastolic dysfunction. The area-under-curve insulin correlated positively w ith peak mitral flow velocity in late diastole (r=0.375). The mean choleste rol/high-density lipoprotein ratio correlated negatively with mean mitral f low velocity in early diastole (E) peak (r=-0.474). The mean fasting insuli n level correlated negatively with mean E/A ratio (r=-0.387). Conclusion(s): Diastolic dysfunction and increased serum homocysteine conce ntrations may contribute to increased cardiovascular disease risk in patien ts with PCOS. (Fertil Steril(R) 2001;76:511-6. (C) 2001 by American Society for Reproductive Medicine.).