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- Title
Evaluating exercise challenge to validate cardiac autonomic dysfunction in lean PCOS phenotype.
- Authors
Mishra, Abha; Sharma, Renuka; Mittal, Pratima; Kapoor, Raj; Srivastav, Shival
- Abstract
Background: Polycystic ovary syndrome (PCOS) is frequently associated with infertility, obesity, hypertension, and diabetes mellitus. Cardiac autonomic dysfunction is well documented in long-term patients of PCOS, with impairment being proportionate to disease duration. However, there is paucity of literature on cardiac autonomic tone in the "lean" phenotype of PCOS. We used exercise challenge to probe for autonomic dysfunction, as assessed by heart rate variability (HRV), an index of cardiac autonomic tone. Methods: Our study population consisted of 27 newly diagnosed PCOS patients and 25 healthy females matched by age and body mass index. Short-term HRV was assessed using time and frequency domain indices. Moderate, isotonic exercise was used as an interventional tool. Indices of both groups were compared in three bins – at baseline, immediate, and late postexercise stages. Results: The groups had comparable HRV indices at baseline. However, low-frequency (LF) power was significantly reduced in PCOS patients during immediate and late postexercise phases when compared with controls (p = 0.03 and 0.03, respectively). Time domain indices also exhibited a fall postexercise, although not statistically significant. Conclusions: Although "lean" phenotype PCOS patients had comparable HRV parameters as controls at baseline, the administration of exercise challenge led to reduced sympathetic drive, evident by reduced LF power in patient group. This may be due to latent autonomic dysfunction in "lean" PCOS, which is unmasked on exposure to exercise challenge. We propose that the evaluation of HRV response to exercise may serve as a sensitive screening tool to detect early cardiovascular dysfunction in newly diagnosed lean PCOS patients.
- Subjects
CARDIOVASCULAR innervation; AGE distribution; AUTONOMIC nervous system; CARDIOVASCULAR system; CARDIOVASCULAR diseases risk factors; ELECTROCARDIOGRAPHY; EXERCISE tests; HEART rate monitoring; LEANNESS; RISK assessment; POLYCYSTIC ovary syndrome; SYMPATHETIC nervous system; PHENOTYPES; ISOTONIC exercise; COOLDOWN; BODY mass index; ERGOMETRY; EXERCISE tolerance; DISEASE complications
- Publication
Journal of Basic & Clinical Physiology & Pharmacology, 2019, Vol 30, Issue 4, pN.PAG
- ISSN
0792-6855
- Publication type
Article
- DOI
10.1515/jbcpp-2018-0198