Table 1 Study characteristics
First author and year of publication | Study design | Country | Publication language | PCOS diagnosis criteria | BMI Status | No. PCOS | No. Controls | Cardiovascular parameters | Anthropometric features | Major Findings |
|---|---|---|---|---|---|---|---|---|---|---|
Yildirir et al, 2006 [45] | Case- control | Turkey | English | NIH | Overweight | 30 | 30 | HF, LF, HFnu, LFnu, LF/HF ratio | Age, BMI, Baseline heart rate, SBP, DBP | Significant altered HRV measures in PCOS cases. |
Tekin et al, 2008 [44] | Case- control | Turkey | English | Rotterdam (classic type) | - | 26 | 24 | RMSSD, SDNN, SDANN, pNN50, TP, HF, LF | Age, Baseline heart rate, SBP | Significant alterations in some diagnostic and prognostic parameters gleaned from a standard treadmill exercise test and HRV analysis. |
Di Domenico et al, 2013 [38] | Cross-sectional | Brazil | English | Rotterdam | Obese | 30 | 23 | RMSSD, Mean-RR, PNN50, LFnu, HFnu, LF/HF | Age, BMI, SBP, DBP | 1) Impaired autonomic modulation in response to sympathetic stimulation. 2) Negative and significant correlation between total testosterone levels and frequency domain HRV indices during stress in PCOS. |
Saranya et al, 2014 [37] | Cross-sectional | India | English | Rotterdam | Overweight | 31 | 30 | RMSSD, SDNN, pNN50, NN50, mean-RR, TP, HF, LF, HFnu, LFnu, LF/HF ratio | Age, BMI, Baseline heart rate, SBP, DBP | 1) Significant alterations of HRV measures in PCOS cases. 2) Significant correlation between LF/HF ratio and BMI, WHR, heart rate. |
Kuppusamy et al, 2015 [36] | Cross-sectional | Inida | English | Rotterdam | Overweight | 35 | 32 | RMSSD, SDNN, pNN50, NN50, mean-RR, TP, HFnu, LFnu, LF/HF ratio | Age, BMI, Baseline heart rate, SBP, DBP | 1) Significant alterations of HRV measures in PCOS cases. 2) Significant correlation between LF/HF ratio and BMI, heart rate and IR. |
Hashim et al, 2015 (1) [39] | Cross-sectional | Iraq | English | Rotterdam | - | 32 | 20 | RMSSD, SDNN, SDANN, pNN50 | SBP, DBP | No significant changes of HRV measures in PCOS cases. |
Hashim et al, 2015 (2) [39] | Cross-sectional | Iraq | English | Rotterdam | Obese | 32 | 20 | RMSSD, SDNN, SDANN, pNN50 | BMI, SBP, DBP | 1) Significant alterations of HRV measures in PCOS cases. 2) Negative correlation between SDNN and WHR. |
Balamurugan et al, 2015 [41] | Case- control | India | English | Rotterdam | Normal | 24 | 24 | RMSSD, SDNN, NN50, pNN50, mean-RR, HF, LF, HFnu, LFnu, LF/HF ratio | Age, BMI, SBP, DBP, Baseline heart rate | Altered cardiac autonomic activity and unfavorable metabolic profile in PCOS cases. |
Lambert et al, 2015 [20] | Case- control | Austria | English | Rotterdam | Obese | 19 | 21 | RMSSD, SDNN, mean-RR, HFnu, LFnu, LF/HF ratio | Age, BMI, Baseline heart rate, SBP, DBP | No significant changes of HRV measures in PCOS cases. |
Balamurugan et al, 2016 [40] | Case- control | India | English | WHO | Normal | 24 | 24 | TP | BMI, SBP, DBP, Baseline heart rate | Decreased total variability of heart rate in lean and ideal weight PCOS. |
Özkeçeci et al, 2016 [21] | Case- control | Turkey | English | NIH | Normal | 23 | 25 | RMSSD, SDNN, SDANN | Age, BMI, Baseline heart rate, SBP, DBP | No significant changes of HRV measures in PCOS cases. |
Ribeiro et al, 2016 [23] | Case- control | Brazil | English | Rotterdam | Overweight | 27 | 26 | Mean-RR, HF, LF, HFnu, LFnu, LF/HF ratio | BMI, Baseline heart rate, SBP, DBP | 1) Altered cardiac autonomic activity in both supine and tilt position in PCOS cases. 2) Positive correlation between the LF/HF ratio and the testosterone/ androstenedione ratio 3) Negative correlation between the LF/HF ratio and androstenedione |
Kilit et al, 2017 [22] | Case- control | Turkey | English | Rotterdam | Normal | 60 | 60 | RMSSD, SDNN, mean-RR, HF, LF, HFnu, LFnu, LF/HF ratio | Age, BMI, SBP, DBP | No significant changes of HRV measures in PCOS cases. |
Velusami et al, 2018 [24] | Cross-sectional | India | English | Rotterdam | Overweight | 30 | 30 | RMSSD, SDNN, Mean-RR, LFnu, HFnu, LF/HF, TP | Age, BMI, SBP, DBP, Baseline heart rate | 1) Significant changes of HRV measures in PCOS cases. 2) Significant association of BMI with sympathovagal imbalance. |
Ji et al, 2018 [25] | Cross-sectional | Korea | English | Rotterdam | Normal | 35 | 32 | RMSSD, SDNN, HF, LF, HFnu, LFnu, LF/HF ratio | Age, BMI, Baseline heart rate, SBP, DBP | Significant changes of HRV measures in PCOS cases. |
Philbois et al, 2019 (1) [46] | Case- control | Brazil | English | Rotterdam (classic type) | Overweight | 30 | 30 | mean-RR, HF, LF, HFnu, LFnu, LF/HF ratio | Age, BMI, Baseline heart rate, SBP, DBP | No significant change in autonomic cardiovascular control in non-obese PCOS cases. |
Philbois et al, 2019 (2) [46] | Case- control | Brazil | English | Rotterdam (classic type) | Obese | 30 | 30 | mean-RR, HF, LF, HFnu, LFnu, LF/HF ratio | Age, BMI, Baseline heart rate, SBP, DBP | Significant attenuated HRV values in obese-PCOS cases. |
Mishra et al,2019 [42] | Case- control | India | English | Rotterdam | Normal | 27 | 25 | RMSSD, SDNN, NN50, LF, HF, LF/HF, TP | Age, BMI | 1) Significant changes of HRV measures in PCOS cases. 2) Isotonic exercise challenge can be a useful tool in the assessment of autonomic fitness in PCOS patients. |
Ribeiro et al, 2020 [43] | Case- control | Brazil | English | Rotterdam | Overweight | 32 | 32 | RMSSD, mean-RR, HF, LF, HFnu, LFnu, LF/HF ratio | Age, BMI | Altered cardiac autonomic activity in both supine and tilt position in PCOS cases. |