TY - JOUR
T1 - The impact of menopausal hormone therapy (MHT) on cardiac structure and function
T2 - Insights from the UK Biobank imaging enhancement study
AU - Sanghvi, Mihir M.
AU - Aung, Nay
AU - Cooper, Jackie A.
AU - Paiva, José Miguel
AU - Lee, Aaron M.
AU - Zemrak, Filip
AU - Fung, Kenneth
AU - Thomson, Ross J.
AU - Lukaschuk, Elena
AU - Carapella, Valentina
AU - Kim, Young Jin
AU - Harvey, Nicholas C.
AU - Piechnik, Stefan K.
AU - Neubauer, Stefan
AU - Petersen, Steffen E.
N1 - Publisher Copyright:
© 2018 Sanghvi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2018/3
Y1 - 2018/3
N2 - Background The effect of menopausal hormone therapy (MHT)–previously known as hormone replacement therapy–on cardiovascular health remains unclear and controversial. This cross-sectional study examined the impact of MHT on left ventricular (LV) and left atrial (LA) structure and function, alterations in which are markers of subclinical cardiovascular disease, in a population-based cohort. Methods Post-menopausal women who had never used MHT and those who had used MHT 3 years participating in the UK Biobank who had undergone cardiovascular magnetic resonance (CMR) imaging and free of known cardiovascular disease were included. Multivariable linear regression was performed to examine the relationship between cardiac parameters and MHT use 3 years. To explore whether MHT use on each of the cardiac outcomes differed by age, multivariable regression models were constructed with a cross-product of age and MHT fitted as an interaction term. Results Of 1604 post-menopausal women, 513 (32%) had used MHT 3 years. In the MHT cohort, median age at menopause was 50 (IQR: 45–52) and median duration of MHT was 8 years. In the non-MHT cohort, median age at menopause was 51 (IQR: 48–53). MHT use was associated with significantly lower LV end-diastolic volume (122.8 ml vs 119.8 ml, effect size = -2.4%, 95% CI: -4.2% to -0.5%; p = 0.013) and LA maximal volume (60.2 ml vs 57.5 ml, effect size = -4.5%, 95% CI: -7.8% to -1.0%; p = 0.012). There was no significant difference in LV mass. MHT use significantly modified the effect between age and CMR parameters; MHT users had greater decrements in LV end-diastolic volume, LV end-systolic volume and LA maximal volume with advancing age. Conclusions MHT use was not associated with adverse, subclinical changes in cardiac structure and function. Indeed, significantly smaller LV and LA chamber volumes were observed which have been linked to favourable cardiovascular outcomes. These findings represent a novel approach to examining MHT’s effect on the cardiovascular system.
AB - Background The effect of menopausal hormone therapy (MHT)–previously known as hormone replacement therapy–on cardiovascular health remains unclear and controversial. This cross-sectional study examined the impact of MHT on left ventricular (LV) and left atrial (LA) structure and function, alterations in which are markers of subclinical cardiovascular disease, in a population-based cohort. Methods Post-menopausal women who had never used MHT and those who had used MHT 3 years participating in the UK Biobank who had undergone cardiovascular magnetic resonance (CMR) imaging and free of known cardiovascular disease were included. Multivariable linear regression was performed to examine the relationship between cardiac parameters and MHT use 3 years. To explore whether MHT use on each of the cardiac outcomes differed by age, multivariable regression models were constructed with a cross-product of age and MHT fitted as an interaction term. Results Of 1604 post-menopausal women, 513 (32%) had used MHT 3 years. In the MHT cohort, median age at menopause was 50 (IQR: 45–52) and median duration of MHT was 8 years. In the non-MHT cohort, median age at menopause was 51 (IQR: 48–53). MHT use was associated with significantly lower LV end-diastolic volume (122.8 ml vs 119.8 ml, effect size = -2.4%, 95% CI: -4.2% to -0.5%; p = 0.013) and LA maximal volume (60.2 ml vs 57.5 ml, effect size = -4.5%, 95% CI: -7.8% to -1.0%; p = 0.012). There was no significant difference in LV mass. MHT use significantly modified the effect between age and CMR parameters; MHT users had greater decrements in LV end-diastolic volume, LV end-systolic volume and LA maximal volume with advancing age. Conclusions MHT use was not associated with adverse, subclinical changes in cardiac structure and function. Indeed, significantly smaller LV and LA chamber volumes were observed which have been linked to favourable cardiovascular outcomes. These findings represent a novel approach to examining MHT’s effect on the cardiovascular system.
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U2 - 10.1371/journal.pone.0194015
DO - 10.1371/journal.pone.0194015
M3 - Article
C2 - 29518141
AN - SCOPUS:85043448523
SN - 1932-6203
VL - 13
JO - PloS one
JF - PloS one
IS - 3
M1 - e0194015
ER -
