Estrous cycle phase affects myocardial infarction through reactive oxygen species and nitric oxide

Myocardial infarction is the leading cause of death in women worldwide. Several studies have shown that estrogens play a cardioprotective role in women by decreasing reactive oxygen species (ROS) and increasing nitric oxide (NO). The aim of this work was to determine whether the evolution of myocardial infarction depends on the phase of the estrous cycle.

Female Wistar rats were randomized into the following groups with an (n = 7 per group): (1) ovariectomized (OVX-sham); (2) OVX-48 h coronary occlusion (CO); (3) OVX-2 w CO; (4) proestrus-sham; (5) proestrus-48 h CO; (6) proestrus-2 w CO; (7) estrus-sham; (8) estrus-48 h CO; and (9) estrus-2 w CO. We measured the percentage of myocardial necrosis, cardiac hypertrophy, hemodynamic parameters, and the production of NO and ROS, after acute and chronic myocardial infarction was induced in proestrus or estrus or ovariectomized female rats.

The infarct area was reduced in the proestrus groups, while it was increased in the estrus and OVX groups. The left ventricular systolic pressure (LVSP) and ± dP/dt were reduced, but left ventricular diastolic pressure (LVDP) was increased in the OVX groups. NO was increased in the OVX + CO and estrus + CO groups. Production of ROS was increased in OVX rats after myocardial infarction but remained unchanged in proestrus and estrus.

The phase of the estrous cycle in which the myocardial infarction occurs is important. When the coronary occlusion occurs during the proestrus phase, it prevents changes in cardiac function, the development of hypertrophy, oxidative stress and changes in NO levels, and reduces the extent of infarction.