Author + information
- Received August 1, 2018
- Revision received December 14, 2018
- Accepted December 27, 2018
- Published online February 25, 2019.
- Petra Zubin Maslov, MD, PhDa,
- Jin Kyung Kim, MD, PhDb,
- Edgar Argulian, MDc,
- Amir Ahmadi, MDc,
- Nupoor Narula, MDd,
- Mandeep Singh, MDe,
- Jeroen Bax, MD, PhDf and
- Jagat Narula, MD, PhDc,∗ ()
- aDepartment of Internal Medicine, Mount Sinai St Luke’s Hospital and Mount Sinai West Hospital, New York, New York
- bDivision of Cardiology, Department of Medicine, University of California, Irvine School of Medicine, Irvine, California
- cDepartment of Cardiology, Mount Sinai St Luke’s Hospital, New York, New York
- dDivision of Cardiology, Weill Cornell Medicine, New York, New York
- eDepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
- fDepartment of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
- ↵∗Address for correspondence:
Dr. Jagat Narula, Mount Sinai Heart, 1190 Fifth Avenue, 1 Gustave L. Levy Place, GP-1W, Box 1030, New York, New York 10021.
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.
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received August 1, 2018.
- Revision received December 14, 2018.
- Accepted December 27, 2018.
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