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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This issue of the Brazilian Archives of Cardiology (ABC Cardiol) brings the article “Women with Polycystic Ovarian Syndrome Exhibit Reduced Baroreflex Sensitivity That May Be Associated with Increased Body Fat”, by Philbois, SV et al., which draws attention to this clinical condition that is so prevalent in our country and its many aspects related to cardiometabolism, neuroregulation and cardiovascular risk.

The Polycystic Ovary Syndrome (PCOS) is the most common endocrine disorder in women of reproductive age, with an estimated prevalence of 6 to 10% in this population. According to the Rotterdam criteria, PCOS is diagnosed in the presence of at least two of the three criteria: menstrual disorders or amenorrhea with chronic lack of ovulation, clinical and/or biochemical characteristics of hyperandrogenism and the presence of polycystic ovaries on ultrasonography after exclusion of other endocrine disorders. Overall, SOP has been considered a reproductive disorder; however, it also represents a significantly increased risk for cardiometabolic disorders. The impact on reproduction is predominant during the reproductive years, while cardiometabolic alterations become more important in the later stages of a woman’s life.

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