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Diuretic Therapy for Patients With Heart Failure JACC State-of-the-Art Review The spectrum of heart failure: value of left ventricular ejection fraction and its moving trajectories Randomized Trial of Stents Versus Bypass Surgery for Left Main Coronary Artery Disease: 5-Year Outcomes of the PRECOMBAT Study Angiotensin–neprilysin inhibition versus enalapril in heart failure 中国心力衰竭诊断和治疗指南2018 Novel percutaneous interventional therapies in heart failure with preserved ejection fraction: an integrative review Frequency, predictors, and prognosis of ejection fraction improvement in heart failure: an echocardiogram-based registry study Effect of Intravascular Ultrasound-Guided Drug-Eluting Stent Implantation: Five-Year Follow-Up of the IVUS-XPL Randomized Trial Outcomes After Left Main Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting According to Lesion Site Results From the EXCEL Trial Vaccination Trends in Patients With Heart Failure - Insights From Get With The Guidelines–Heart Failure
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Review ArticleVolume 7, Issue 3, March 2019

JOURNAL：JACC: Heart Failure Article Link

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

P Z Maslov, JK Kim, E Argulian et al. Keywords: diastolic function; estrogen; HFpEF; post-menopausal

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.

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