Arq. Bras. Cardiol. 2021; 116(4): 812-813
Pulmonary Hypertension in Polycystic Ovarian Syndrome
This Short Editorial is referred by the Research article "Increased Pulmonary Arterial Stiffness and Impaired Right Ventricle-Pulmonary Artery Coupling In PCOS".
Polycystic Ovarian Syndrome (PCOS) is a complex endocrinological syndrome that presents in women with obesity, insulin resistance and sex hormone abnormalities. It is intriguing that in otherwise ‘idiopathic’ pulmonary hypertension, there also seems to be a high prevalence of the same features of obesity, insulin resistance, and sex hormone abnormalities.– However, despite this overlap and a theoretical risk of pulmonary hypertension in PCOS, little is known about the intersection of the two conditions. Given the young age of patients at the time of PCOS diagnosis, only subtle impairments in left heart function have been consistently described,, with overt cardiovascular disease often manifesting many decades later., But, surprisingly, little is known about subclinical right heart remodeling or pulmonary hypertension in this condition.
On this background, Abacioglu et al. provide novel information on cardiac structural remodeling in patients with PCOS, with careful attention to right heart structure and function. They included 44 patients with PCOS and 60 matched controls who underwent comprehensive echocardiography and insulin resistance assessment by the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). In addition to left heart measures of diastolic function, the authors also performed pulse wave Doppler of the right ventricular outflow tract to estimate pulmonary arterial stiffness, and used the well validated TAPSE/RVSP ratio to quantify RV-PA coupling.
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