Evaluation of left ventricular longitudinal myocardial function in patients with polycystic ovary syndrome associated with insulin resistance by cardiac motion quantification
DU Qigen MI Xiangqin XU Hongwei SHANG Weimin ZHOU Liping CHEN Wei▲
Department of Ultrasound, Second Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Heilongjiang Province, Harbin 150000, China
Abstract：Objective To investigate the clinical value of myocardial motion quantification (CMQ) in evaluation of left ventricular longitudinal motion in patients with polycystic ovary combined with insulin resistance (PCOS-IR). Methods From the February 2016 to February 2017, 55 patients with PCOS-IR in Department of Gynecology, the Second Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine were selected, 55 age matched healthy women were selected as control group. The general data were recorded: waist-to-hipratio (WHR), body mass index (BMI), systolic pressure (SBP), diastolic pressure (DBP), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), fasting blood glucose (FPG), fasting plasma insulin (FINS), homeostasis model assessment for IR index (HOMA-IR), and all subjects were given routine echocardiography, the left ventricular end-diastolic dimension (LVDd) and left ventricular end-systolic diameter (LVDs), end-diastolic interventricular septum thickness (IVSTd), end-diastolic left ventricular posterior wall thickness (LVPWTd), and left ventricular ejection fractional (LVEF), early diastolic blood flow peak velocity (E), late diastolic blood flow peak velocity (A), mitral annular early diastolic motion peak velocity (Em) were measured, E/A and E/Em were calculated, E peak deceleration time (DT), isovolumic relaxation time (IVRT) and isovolumic contraction time (IVCT) were measured. CMQ technique was used to trace tracing of myocardial trajectory, and systolic longitudinal peak strain (LS) and systolic global longitudinal peak strain (GLS) of 18 left ventricular segments were obtained. Pearson correlation was used to analyze the correlation between the parameters. Results The WHR, BMI, FINS, HOMA-IR and LDL-C in the PCOS-IR group were higher than those in the control group, the differences were statistically significant (P < 0.05); there was no significant difference in age, SBP, DBP, FPG, HDL-C, TG between the two groups (P > 0.05). Compared with the control group, DT, IVRT, E/Em increased in the PCOS-IR group, and Em decreased, the differences were statistically significant (P < 0.05); there was no significant difference in LVDd, LVDs, IVSTd, LVPWTd, LVEF, E, A, E/A, IVCT between the two groups (P > 0.05). The LS and GLS in each segment of PCOS-IR group were lower than those in the control group, the differences were statistically significant (P < 0.05). There were negative correlations between GLS and FINS, WHR, LDL-C (r = -0.58, -0.46, -0.44, all P < 0.05). There was no correlation between GLS and FPG, HOMA-IR, HDL-C, TG, BMI (P > 0.05). Conclusion Patients with PCOS-IR may show a decline in early longitudinal systolic function under normal LVEF. CMQ technology can detect early left ventricular longitudinal movement abnormalities in patients with PCOS-IR, and provide clinical help for timely intervention.
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2018, Vol. 15 
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