Analysis of Heart Rate Variability in Women with Polycystic Ovary Syndrome (PCOS)

PCOS is a growing health problem of young adolescent girls and women in reproductive age group. Metabolic and cardiovascular disorders commonly seen in PCOS suggests that autonomic imbalance might have a role in the pathogenesis of PCOS. Increased anxiety and depression due to the reproductive and metabolic disorders seen in PCOs further worsen the quality of life. The variation of the heart rate from beat to beat known as the heart rate variability(HRV) has been used to determine the balance between sympathetic and vagal nerve activities in the heart.

To evaluate the autonomic activity in women with PCOS by assessing the resting heart rate variability and comparing with that of normal controls.

Thirty women with PCOs diagnosed as per the Rotterdam's criteria, of age group between 20–35 years, attending an infertility clinic were selected as cases and thirty age matched apparently healthy women from the community were selected as controls for the study. Resting HRV was analysed using Niviqure ambulatory digital ECG recorder (INCO). Mean RR, Mean HR, sDNN, RMssD, pNN50, Total power, low frequency (LF), High frequency (HF) and LF/HF were estimated. Independent student t test was employed as the Test of significance at 95% confidence interval. p value <0.05 was considered as significant.

Resting HRV analysis showed a significant change in frequency domain measures with increase in LFnu, (48.83±13.2 vs 38.27±9.9), LF/HF ratio (1.16±0.57 vs 0.70±0.28) and decrease in HFnu, (50.78±12.7vs 57.21±10.9)in women with PCOs compared to the controls respectively. All time domain measures except pNN50 was reduced but none of them was significant.

Resting HRV analysis indicate that there is a definite sympathovagal imbalance in women with PCOS in the form of sympathetic overactivity and parasympathetic withdrawal. Approaches targeting sympathetic nervous system might have a therapeutic role in PCOS.