Is Cardiac Diastolic Dysfunction a Part of Post-Menopausal Syndrome?

JACC. Heart Failure
Petra Zubin MaslovJagat Narula

Abstract

Post-menopausal women exhibit an exponential increase in the incidence of heart failure with preserved ejection fraction compared with men of the same age, which indicates a potential role of hormonal changes in subclinical and clinical diastolic dysfunction. This paper reviews the preclinical evidence that demonstrates the involvement of estrogen in many regulatory molecular pathways of cardiac diastolic function and the clinical data that investigates the effect of estrogen on diastolic function in post-menopausal women. Published reports show that estrogen deficiency influences both early diastolic relaxation via calcium homeostasis and the late diastolic compliance associated with cardiac hypertrophy and fibrosis. Because of the high risk of diastolic dysfunction and heart failure with preserved ejection fraction in post-menopausal women and the positive effects of estrogen on preserving cardiac function, further clinical studies are needed to clarify the role of endogenous estrogen or hormone replacement in mitigating the onset and progression of heart failure with preserved ejection fraction in women.

Citations

Sep 23, 2020·Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology·Jian-Shu ChenJing Yu
Jan 30, 2020·Frontiers in Endocrinology·Leanne GrobanSarah H Lindsey
Sep 29, 2020·Current Heart Failure Reports·Andrew OnegliaC Noel Bairey Merz
Jul 6, 2020·Current Hypertension Reports·Karnika AyinapudiSuzanne Oparil
Jan 21, 2021·International Journal of Environmental Research and Public Health·Valentina BucciarelliSabina Gallina
May 8, 2021·The Journal of Clinical Hypertension·Anping CaiYingqing Feng
Jun 16, 2021·Menopause : the Journal of the North American Menopause Society·Wendy YingDhananjay Vaidya

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