Associations between menopause, cardiac remodeling, and diastolic function: the CARDIA study
Wendy Ying1, Wendy S Post1,2, Erin D Michos1,2
1Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
Menopause (New York, N.Y.)
|June 15, 2021
Summary
Menopause is linked to poorer diastolic function and adverse cardiac remodeling in women. This may increase the risk of heart failure with preserved ejection fraction (HFpEF) in postmenopausal individuals.
Area of Science:
- Cardiology
- Women's Health
- Menopause Research
Background:
- Heart failure with preserved ejection fraction (HFpEF) is more prevalent in women.
- Menopause is a potential contributing factor to HFpEF development in women.
Purpose of the Study:
- To assess the cross-sectional and longitudinal associations between menopause and echocardiographic measures of left ventricular (LV) function and cardiac remodeling.
Main Methods:
- 1,723 women from the Coronary Artery Risk Development in Young Adults study with serial echocardiography data were analyzed.
- Cardiac structure and function were assessed using 2D and Doppler echocardiography.
- Linear mixed models and two-segmented models were used to analyze cross-sectional and longitudinal changes, respectively.
Main Results:
- Postmenopausal women exhibited a higher early diastolic mitral inflow (E) to annular (e') velocity ratio compared to premenopausal women.
- Menopause was associated with increased rates of change in LV mass and left atrial volume.
- The change in the E/e' ratio was comparable before and after menopause.
Conclusions:
- Menopause is associated with worse diastolic function and adverse cardiac remodeling in women.
- These menopausal effects may contribute to the higher risk of HFpEF observed in postmenopausal women.
Related Concept Videos
01:29Heart Failure II: Pathophysiology
133
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
133
01:30Cardiomyopathy II: Dilated Cardiomyopathy
111
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
111
01:29Cardiomyopathy V: Interprofessional Care
93
Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
93
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy
109
Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
109
01:29Cardiomyopathy IV: Restrictive Cardiomyopathy
142
Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...
142
01:30Coronary Artery Disease I: Introduction
565
Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...
565