Menopause-induced changes in doppler-derived parameters of aortic flow in healthy women

Pines, Amos; Fisman, Enrique Z.; Drory, Yaacov; Levo, Y; Shemesh, Joseph; Ben-Ari, Efraim; Ayalon, Daniel

doi:10.1016/0002-9149(92)90877-2

Cited by 62 publications

(20 citation statements)

References 19 publications

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“…4,16 In their 2 consecutive studies, Pines et al have found that cardiac functions deteriorated in postmenopausal women and that this effect was more pronounced as the duration of menopause increased. 5,6 Prelevic et al have also demonstrated that EF and aortic flow velocities are lower in postmenopausal women than in premenopausal women. 17 The significant age difference between pre-and postmenopausal women in these studies have caused dispute among investigators as to whether these cardiac structural and functional changes are related to aging or menopause.…”

Section: Discussionmentioning

confidence: 98%

“…The effects of menopause on cardiac structure and function have not been investigated adequately. Interpretation of the results of the few previous studies [4][5][6] comparing pre-and postmenopausal women comprises some difficulties, owing to significant age differences and small sample sizes. Moreover, cardiac functions have been evaluated only by conventional 2-dimensional (D) and M-mode echocardiography in these studies, thus the extent of influence on more recent echocardiographic parameters after menopause have not been adequately analyzed.…”

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confidence: 99%

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Effects of Menopause on the Myocardial Velocities and Myocardial Performance Index

Düzenli

Özdemi̇r

Sökmen

et al. 2007

Circ J

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enopause is a critical period in a woman's life, during which many physiologic and pathologic changes occur. Women spend one-third of their lifetime in this period and the hormonal changes that occur during this period have significant influences on several organs and systems. The cardiovascular system is among the most dramatically affected systems. Changes in cardiovascular risk factors due to estrogen deficiency and subsequent increase in cardiovascular morbidity and mortality have been demonstrated in several studies. [1][2][3] Structural and functional changes in the heart can also occur during the postmenopausal period. The effects of menopause on cardiac structure and function have not been investigated adequately. Interpretation of the results of the few previous studies 4-6 comparing pre-and postmenopausal women comprises some difficulties, owing to significant age differences and small sample sizes. Moreover, cardiac functions have been evaluated only by conventional 2-dimensional (D) and M-mode echocardiography in these studies, thus the extent of influence on more recent echocardiographic parameters after menopause have not been adequately analyzed.Tissue Doppler echocardiography (TDE) is a relatively new technique, which is partially utilized in recent years to evaluate cardiac functions via measurement of myocardial velocities. 7 Also, myocardial performance index (MPI) has been recognized as a parameter that reflects ventricular systolic and diastolic functions. 8,9 To our knowledge, no literature exists on how myocardial velocities, as measured by TDE, which have some advantages over standard echocardiographic methods, and MPI, which provides a more quantitative and global evaluation of left ventricular (LV), are affected by menopause. The present study was designed to investigate how myocardial velocities measured by TDE and MPI, which together provide more quantitative data on regional and global ventricular functions, are affected by menopause. Methods Study PopulationSubjects were selected from healthy women admitted to the gynecology and obstetrics, and cardiology outpatient departments between 2001 and 2006. After informed consent was obtained, a prospective analysis was performed. Body weight and height of all subjects were measured and body mass index was calculated. Fasting blood samples were drawn for biochemical and hematological investigations and ECGs were done. An exercise stress test using Bruce protocol and subsequent echocardiographic evaluations were performed. Postmenopausal status was confirmed as being in menopause for at least 12 months with serum follicle-stimulating hormone (FSH) levels of >30 mU/ml and estrogen levels of <20 pg/ml, and premenopausal status Effects of Menopause on the Myocardial Velocities and Myocardial Performance IndexMehmet Akif Düzenli, MD; Kurtulus Ozdemir, MD; Abdullah Sokmen, MD**; Ahmet Soylu, MD; Nazif Aygul, MD; Kazim Gezginc, MD*; Mehmet Tokac, MD Background Although menopause is known to increase cardiovascular risk and mortality, the effect ...

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Section: Discussionmentioning

confidence: 98%

mentioning

confidence: 99%

Effects of Menopause on the Myocardial Velocities and Myocardial Performance Index

Düzenli

Özdemi̇r

Sökmen

et al. 2007

Circ J

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“…Gangar et al 15 found that the pulsatility index of the internal carotid artery was inversely correlated with the time elapsed since the last menstrual bleeding and that oestrogen replacement therapy normalised the raised pulsatility index. 15 In the ascending aorta, Pines et al 16 demonstrated a gradual decline in Doppler-derived peak flow velocity, flow velocity integral and mean flow acceleration in women who went through menopause. In an earlier study 17 the same authors had shown that hormonal replacement therapy produced a significant improvement in these aortic flow measurements.…”

Section: Discussionmentioning

confidence: 99%

Menopause and the characteristics of the large arteries in a population study

et al. 2001

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In previous cross-sectional and longitudinal population studies, we found that the slope of systolic pressure on age was steeper in postmenopausal than in premenopausal women. We hypothesised that this observation could be due to a specific effect of menopause on the elasticity of the large arteries. We investigated 315 randomly selected women, aged 30 to 70 years. Based on 5.2 years of follow-up, 166 women were premenopausal and 149 menopausal (44 reaching menopause and 105 postmenopausal). These women were matched on age and body mass index with 315 men. We used a walltracking ultrasound system to measure the diameter, compliance and distensibility of the brachial and the common carotid and femoral arteries as well as carotidfemoral pulse wave velocity. Pulse pressure was determined from 24-h blood pressure recordings. Both in menopausal women (r = 0.37; P Ͻ 0.001) and in matching male controls (r = 0.16; P = 0.04), pulse pressure widened with increasing age. The slope of the 24-h pulse pressure on age was steeper in menopausal

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“…Furthermore, the decrease noted in aortic flow Doppler-derived parameters during menopause, also appears to be gradual [26]. This decrease causes the observed aortic flow differences between pre and post menopausal women, which widen gradually as menopause advances and estrogen levels decline [26]. Estrogens are known to increase stroke volume, cardiac output and flow acceleration, whilst decreasing total peripheral resistance, probably through a combination of vasodilation and enhanced inotropism [13,25,27,28].…”

Section: Doppler Flow Parametersmentioning

confidence: 98%

Exercise‐induced aortic flow parameters in early postmenopausal women and middle‐aged men

Pines

Drory

et al. 1998

Journal of Internal Medicine

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Objective. Exercise Doppler echocardiography has been recognised as an accurate method for the assessment of left ventricular function in patients with coronary artery disease. Gender differences in aortic flow parameters during exercise have not been well established. The aims of this study were to compare basal ejection Doppler indexes in healthy early postmenopausal women with those of men, and to assess the effects of both isometric and dynamic exercises on these parameters. Design. Intergroup comparison between early postmenopausal women and middle-aged men Subjects. Fifteen healthy women with a mean age of 55 (SD 5) years and 15 healthy men aged 52 (SD 4) were evaluated.Setting. Women were recruited from a menopause clinic and men from a primary cardiovascular prevention program at a cardiac rehabilitation institute. Interventions. Isometric exercise was performed with a 2-hand bar dynamometer, and dynamic exercise with a supine ergometer. Echo Doppler examination was performed at rest and at peak isometric and dynamic exercise with a pulsed Doppler transducer. Results. Both types of exercise resulted in higher values of hemodynamic parameters in the women, with most figures reaching statistical significance. Most aortic flow parameters during rest and exercise were also significantly higher in the women. Conclusions. The unexpected higher values in hemodynamic and aortic flow parameters in early postmenopausal women as compared with middle aged men may shed light on a peculiar aspect of gender differences in cardiovascular function, perhaps specific to this age group and related to menopausal transition.

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Menopause-induced changes in doppler-derived parameters of aortic flow in healthy women

Cited by 62 publications

References 19 publications

Effects of Menopause on the Myocardial Velocities and Myocardial Performance Index

Effects of Menopause on the Myocardial Velocities and Myocardial Performance Index

Menopause and the characteristics of the large arteries in a population study

Exercise‐induced aortic flow parameters in early postmenopausal women and middle‐aged men

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