Atherosclerosis

2016

DOI: 10.1016/j.atherosclerosis.2015.11.011

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Subclinical atherosclerotic risk in endurance-trained premenopausal amenorrheic women

Jacqueline A. Augustine

¹

,

Wesley K. Lefferts

²

,

Jodi N. Dowthwaite

³

et al.

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Cited by 15 publications

(17 citation statements)

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“…In fact, similar degree of subclinical atherosclerosis has been reported between athletes and controls [9,10]. In addition, lower rates of cardiovascular disease have been described in pre-menopausal women, in the general population [11], but female athletes may have hormonal disturbances that can abolish the vascular protection against atherosclerosis [10,12]. Furthermore, flow-mediated dilation, an endothelial vascular marker capable to predict long-term cardiovascular events [13], seems impaired in athletes, possibly due to differences in artery size and wall thickness [14].…”

Section: Introductionsupporting

confidence: 71%

“…In fact, similar degree of subclinical atherosclerosis has been reported between athletes and controls [9,10]. In addition, lower rates of cardiovascular disease have been described in pre-menopausal women, in the general population [11], but female athletes may have hormonal disturbances that can abolish the vascular protection against atherosclerosis [10,12].…”

Section: Introductionmentioning

confidence: 81%

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Effects of High-Intensity Training of Professional Runners on Myocardial Hypertrophy and Subclinical Atherosclerosis

¹

,

²

,

³

et al. 2016

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To evaluate the effects of long-term exposure to high-intensity training among professional runners on cardiac hypertrophy and subclinical atherosclerosis.Prospective study included runners of both sexes (n = 52) and age and gender matched controls (n = 57), without classical cardiovascular risk factors. Ventricular hypertrophy was quantified by echocardiography by linear method and carotid intima-media thickness (cIMT) by 2-D images obtained by ultrasonography. Endothelial function was evaluated by flow-mediated dilation (FMD). Steroid hormones were quantified by HPLC followed by LC-MS/MS. Higher left ventricular (LV) mass index was found in male athletes (p<0.0001 vs. other groups). When adjusted for gender, the degree of left ventricular mass index classified as mildly, moderately or severely abnormal was obtained in 26%, 35%, and 30%, respectively, of female athletes, and in 39%, 14%, and 21%, respectively, of male athletes. Higher ratio of the early (E) to late (A) ventricular filling velocities was found in athletes of both genders. Male athletes presented lower cIMT in the right (p = 0.012 vs. male controls) and left (p<0.0001 vs. male controls) common carotid arteries, without differences in cIMT between female athletes and controls. FMD results were similar among groups. Higher serum testosterone levels were found in male athletes (p<0.0001 vs. other groups) and they were correlated with LV mass (r = 0.50, p<0.0001). The chronic exposure of high-intensity training among professional runners of both genders was associated with increased ventricular mass and adaptive remodeling. Less subclinical atherosclerosis was found in male athletes. Differences in steroid hormones may account in part for these findings.

“…In fact, similar degree of subclinical atherosclerosis has been reported between athletes and controls [9,10]. In addition, lower rates of cardiovascular disease have been described in pre-menopausal women, in the general population [11], but female athletes may have hormonal disturbances that can abolish the vascular protection against atherosclerosis [10,12]. Furthermore, flow-mediated dilation, an endothelial vascular marker capable to predict long-term cardiovascular events [13], seems impaired in athletes, possibly due to differences in artery size and wall thickness [14].…”

Section: Introductionsupporting

confidence: 71%

“…In fact, similar degree of subclinical atherosclerosis has been reported between athletes and controls [9,10]. In addition, lower rates of cardiovascular disease have been described in pre-menopausal women, in the general population [11], but female athletes may have hormonal disturbances that can abolish the vascular protection against atherosclerosis [10,12].…”

Section: Introductionmentioning

confidence: 81%

Effects of High-Intensity Training of Professional Runners on Myocardial Hypertrophy and Subclinical Atherosclerosis

¹

,

²

,

³

et al. 2016

View full text Add to dashboard Cite

To evaluate the effects of long-term exposure to high-intensity training among professional runners on cardiac hypertrophy and subclinical atherosclerosis.Prospective study included runners of both sexes (n = 52) and age and gender matched controls (n = 57), without classical cardiovascular risk factors. Ventricular hypertrophy was quantified by echocardiography by linear method and carotid intima-media thickness (cIMT) by 2-D images obtained by ultrasonography. Endothelial function was evaluated by flow-mediated dilation (FMD). Steroid hormones were quantified by HPLC followed by LC-MS/MS. Higher left ventricular (LV) mass index was found in male athletes (p<0.0001 vs. other groups). When adjusted for gender, the degree of left ventricular mass index classified as mildly, moderately or severely abnormal was obtained in 26%, 35%, and 30%, respectively, of female athletes, and in 39%, 14%, and 21%, respectively, of male athletes. Higher ratio of the early (E) to late (A) ventricular filling velocities was found in athletes of both genders. Male athletes presented lower cIMT in the right (p = 0.012 vs. male controls) and left (p<0.0001 vs. male controls) common carotid arteries, without differences in cIMT between female athletes and controls. FMD results were similar among groups. Higher serum testosterone levels were found in male athletes (p<0.0001 vs. other groups) and they were correlated with LV mass (r = 0.50, p<0.0001). The chronic exposure of high-intensity training among professional runners of both genders was associated with increased ventricular mass and adaptive remodeling. Less subclinical atherosclerosis was found in male athletes. Differences in steroid hormones may account in part for these findings.

“…For the first time, we report that in comparison to eumenorrheic ovulatory physically active women, estrogen‐deficient ExFHA women demonstrate lower AIx75, suggesting augmented functional arterial compliance of the central arteries. However, our finding of low AWRI contrast that of a recent study reporting similar resting central (aortic) and peripheral pulse wave velocity, a direct marker of arterial stiffness (and its inverse, arterial compliance), in amenorrheic and eumenorrheic athletes . Causes of disparity are unclear, but may be related in part to differences in arterial assessment.…”

Section: Discussionmentioning

confidence: 90%

Indexes of aortic wave reflection are not augmented in estrogen‐deficient physically active premenopausal women

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²

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³

et al. 2020

Scandinavian Med Sci Sports

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Background: Hypoestrogenemia due to menopause is associated with increased cardiovascular disease risk, in part due to elevated indexes of aortic wave reflection (AWRI) and central (aortic) blood pressure. We sought to investigate whether AWRI and central blood pressure are also augmented in hypoestrogenic exercise-trained premenopausal women with functional hypothalamic amenorrhea (ExFHA). Methods: In age-(pooled mean ± SEM, 24 ± 1 years), BMI-(21 ± 1 kg/m 2 ), and cardiorespiratory fitness-matched (45 ± 2 ml/kg/min) eumenorrheic ovulatory (ExOv; n = 11) and ExFHA women (n = 10), we assessed aortic blood pressure and waveform characteristics (augmentation index and wave reflection amplitude) obtained from radial pressure waves (applanation tonometry). Doppler ultrasound determined cardiac output (CO) and total peripheral resistance (TPR). Measures were recorded before and 1 hour after 45 minutes of moderate intensity exercise to determine the influence of exercise-induced increases in nitric oxide. Results: Pre-exercise, AIx75, central systolic BP (SBPc), and CO were lower (P < .05) and TPR higher (P < .05) in ExFHA. Post-exercise, AIx75 was unchanged (P > .05) in ExFHA but was lowered (P < .05) in ExOv. Both groups demonstrated increased CO, and lowered SBPc and TPR, yet TPR remained higher (P < .05), and CO and SBPc lower (P < .05) in ExFHA. Conclusions: Despite hypoestrogenemia, functional compliance of the central arteries and central BP is not augmented, yet TPR is higher, in ExFHA versus ExOv. An acute bout of dynamic exercise did not alter AIx75 in ExFHA, suggesting blunted vascular responsiveness to exercise-induced increases in nitric oxide, possibly due to augmented vascular tone. These findings have relevance in understanding the vascular consequences of hypoestrogenemia during the premenopausal years.

“…Estrogen deficiency induces not only atherogenic lipid abnormalities, but also permit procoagulant oxidative mechanisms and endothelial dysfunction [ 44 ]. Previous studies show that estrogen deficiency in premenopausal women with amenorrhea, leads to decreased FMD [ 45 ]. The postmenopausal status is associated with higher C-IMT, and with an unstable plaque.…”

Section: Discussionmentioning

confidence: 99%

Flow mediated vasodilation compared with carotid intima media thickness in the evaluation of early cardiovascular damage in menopausal women and the influence of biological and psychosocial factors

Sánchez-Barajas

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²

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³

et al. 2018

BMC Women's Health

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BackgroundWomen after menopause increase risk for cardiovascular disease and several factors may be related. The purpose was to study biological and psychosocial factors associated with early cardiovascular damage in pre- and postmenopausal women, assessed with carotid intima-media thickness vs flow-mediated dilatation.MethodsWomen 45 to 57 years old were grouped in the pre- (n = 60), early (n = 58) and late post-menopause (n = 59). Anthropometric, metabolic and hormonal data were registered, as well as measures of depression, anxiety, submission, perceived stress, and sleep alterations. Heart Rate Variability was recorded to obtain the information regarding sympathovagal balance. Carotid intima-media thickness and flow-mediated dilatation were assessed by ultrasound. Two-way ANOVA and multiple regression model were used.ResultsAt late postmenopause, the carotid intima-media was thicker (p < 0.001) and flow-mediated dilatation decreased (p < 0.001). Carotid intima-media thickness was associated positively with age (p < 0.001), submission score (p = 0.029), follicle stimulating hormone levels (p < 0.001), and body mass index (p = 0.009). Flow-mediated dilatation was associated only with age (p < 0.001). Regarding heart rate variability, the time domain pNN50 measurement was higher in premenopausal women (p = 0.001), Low Frequency (LF) was higher in the two groups of postmenopausal (p = 0.001) and High Frequency (HF) higher in the early postmenopausal women (p = 0.042).ConclusionsUnder our conditions carotid intima-media thickness had higher predictive value for early cardiovascular damage at menopause. The finding of the association of the submission score, indicates de influence of stress on vascular damage.

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