Increased Sympathetic Cardiac Autonomic Modulation after Two Consecutive Tilt Tests in Women with Polycystic Ovary Syndrome

• Published in: Revista Brasileira de ginecologia e obstetrícia 2020-02, Vol.42 (2), p.81-89
• Main Authors: Ribeiro, Victor Barbosa, Kogure, Gislaine Satyko, Silva, Rafael Costa, Souza, Hugo Celso Dutra, Ferriani, Rui Alberto, Reis, Rosana Maria Dos
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Arrhythmias, Cardiac - complications; Arrhythmias, Cardiac - physiopathology; cardiac autonomic modulation; Case-Control Studies; Female; Follicle Stimulating Hormone - blood; Humans; hyperandrogenism; Luteinizing Hormone - blood; OBSTETRICS & GYNECOLOGY; Original; polycystic ovary syndrome; Polycystic Ovary Syndrome - blood; Polycystic Ovary Syndrome - complications; Polycystic Ovary Syndrome - diagnostic imaging; Polycystic Ovary Syndrome - physiopathology; spectral analysis; symbolic analysis; Tilt-Table Test; Young Adult
• ISSN: 0100-7203; 1806-9339; 1806-9339
• DOI: 10.1055/s-0040-1701467

The present study aimed to analyze cardiac autonomic modulation via spectral and symbolic analysis of heart rate variability (HRV) in women with polycystic ovary syndrome (PCOS) who were subjected to two consecutive tilt tests.  A total of 64 women were selected and divided into 2 groups: control (without PCOS), and PCOS. Concentrations of follicle-stimulating hormone, luteinizing hormone, prolactin, estradiol, homocysteine, sex hormone-binding globulin, thyroid stimulating hormone, fasting insulin, testosterone, androstenedione, and 17-hydroxyprogesterone levels, triglycerides, free androgen index (FAI), and homeostasis assessment model (HOMA-IR) were assessed. Cardiac autonomic modulation was evaluated by spectral and symbolic analyses during two consecutive tilt tests (two moments) and supine moments before, between and after (three moments) the tilt tests.  Women with PCOS had higher fasting insulin, HOMA-IR indexes, testosterone and FAI. Additionally, we observed that the PCOS group had greater sympathetic autonomic cardiac modulation in supine 2, tilt 1, and supine 3 moments compared with controls.  Women with PCOS had higher autonomic sympathetic cardiac modulation even after a second tilt test. No adaptation to this provocative test was observed. Spectral analysis was more sensitive for identifying differences between groups than the symbolic analysis.