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Diagnostic performance of noninvasive myocardial perfusion imaging using single-photon emission computed tomography, cardiac magnetic resonance, and positron emission tomography imaging for the detection of obstructive coronary artery disease: a meta-analysis Transcatheter aortic-valve replacement with a self-expanding prosthesis Lipid-Modifying Agents, From Statins to PCSK9 Inhibitors: JACC Focus Seminar Lateral Wall Dysfunction Signals Onset of Progressive Heart Failure in Left Bundle Branch Block Simple Electrocardiographic Measures Improve Sudden Arrhythmic Death Prediction in Coronary Disease Randomized comparison of clinical outcomes between intravascular ultrasound and angiography-guided drug-eluting stent implantation for long coronary artery stenoses Incidence, predictors, and outcomes associated with acute kidney injury in patients undergoing transcatheter aortic valve replacement: from the BRAVO-3 randomized trial Contemporary real-world outcomes of surgical aortic valve replacement in 141,905 low-risk, intermediate-risk, and high-risk patients Circadian-Regulated Cell Death in Cardiovascular Diseases Clinical impact of PCSK9 inhibitor on stabilization and regression of lipid-rich coronary plaques: a near-infrared spectroscopy study
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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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