Variations in time domain measures of HRV and analysis of SDNN/RMSSD ratio
as a surrogate for LF/HF in obese women with PCOD

Thirupathi C¹, Sandhya Vadana A², Anbuselvi Mattuvar Kuzhali S³
¹Professor & Director,
²Final year Postgraduate,
³Assistant Professor,
Institute of Physiology & Experimental Medicine,
Madras Medical College,
Chennai – 600003, India

  • Background: Polycystic ovary syndrome is a common heterogeneous endocrine disorder in women of reproductive age where cardiovascular disease is considered as long term health risks. Heart rate variability is a non-invasive test to assess the cardiac autonomic dysfunction in women with PCOS. Estimation of Heart rate variability test could help us to identify women who are at increased risk of developing cardiovascular complications. Inspite of results from other studies, we intended to substantiate a new entity RMSSD/SDNN ratio as a surrogate for LF/HF in women with PCOD.
  • Aim: 1.To analyse and compare the variations in time domain measures of HRV analysis between women (obese and non-obese) with PCOD and non-obese women without PCOD.
    2.To assess the correlation and reliability analysis between SDNN/RMSSD ratio and LF/HF ratio.
  • Methodology: A sample size of 90 women of age group 15-39 years were recruited for this study. Based on the BMI and the clinical diagnosis of PCOD, Women who were diagnosed as PCOS with BMI>25 as Group I (n=30); Women who were diagnosed as PCOS with BMI<25 as Group II (n=30); and age-sex matched clinically normal healthy women with BMI<25 as Group III (controls, n=30). Resting Heart rate variability at 5-minute epoch was recorded for the study group.
  • Results: Significant decreases in time RMSSD, SDNN, mean RR was observed in women (obese and non-obese) with PCOD. A significant negative correlation was found between RMSSD with other variables in the study. RMSSD/SDNN ratio strongly agrees with LF/HF ratio by agreement analysis, whereas by linear regression it was found to be y (RMSSD/SDNN)=1.533 + (0.234)LF/HF.
  • Conclusion: Women with PCOS showed features of autonomic dysfunction with sympathetic predominance and parasympathetic withdrawal. Whether the robustness of SDNN/RMSSD as surrogate for LF/HF needs more confirmation and is suggested for further evaluation, since it had strong correlation in our results with p-value smaller than 0.001.

Keywords: HRV-5-Minute epoch, polycystic ovarian disease, RMSSD/SDNN ratio, surrogate