Effect of Menopausal Hormone Therapy on Cardiac Structure, Function

Menopausal hormone therapy [MHT] was not found to have adverse effects on cardiac structure and function, according to research published in PLoS One.¹ Instead, researchers found smaller left ventricular [LV] and left atrial [LA] chamber volumes, which have been associated with better cardiovascular (CV) outcomes.^2-4

Mihir M. Sanghvi, from the William Harvey Research Institute, NIHR Biomedical Research Centre at Barts, Queen Mary University of London, United Kingdom, and colleagues examined the effect of MHT on LV and LA structure and function changes, which are markers of subclinical CV disease.

In a population-based cohort, 1604 postmenopausal women who had either never used MHT or had used MHT for ≥3 years and had undergone CV magnetic resonance imaging were included in the study. Of the 1604 participants, 513 had used MHT for ≥3 years and mean duration of use was 8 years.

The use of MHT was significantly associated with lower LV end-diastolic volume (1.228 ml vs 119.8 ml, never used MHT vs MHT use; 95% CI, −4.2% to −0.5%, P =.013), LV stroke volume (74 ml vs 72 ml; 95% CI, −5.1% to −1.0%, P =.004), and LA maximal volume (60.2 ml vs 57.5 ml; 95% CI, −7.8% to −1.0%; P =.012).

Age significantly modified the association between CV magnetic resonance parameters and MHT use, with smaller volumes seen with advancing tertiles of age.

No significant difference in LV mass was seen in either group.

Previous studies have linked a reduction in LV and LA volumes, indicative of reverse cardiac remodeling, to better CV outcomes, lower mortality, and a reduced risk for heart failure.^2-4

In postmenopausal women without CV disease, MHT was not found to cause adverse changes in cardiac structure and function. Researchers did find that smaller LV and LA chamber volumes in women who had used MHT, which are linked to better CV outcomes.

References

1. Sanghvi MM, Aung N, Cooper JA, et al. The impact of menopausal hormone therapy (MHT) on cardiac structure and function: insights from the UK Biobank imaging enhancement study. PLoS One. 2018;13(3):e0194015.
2. Cohn JN, Ferrari R, Sharpe N. Cardiac remodeling – concepts and clinical implications: a consensus paper from an international forum on cardiac remodeling. Behalf of an International Forum of Cardiac Remodeling. J Am Coll Cardiol. 2000;35(3):569-582.
3. Kerkhof PL. Characterizing heart failure in the ventricular volume domain. Clin Med Insights Cardiol. 2015; 9(Suppl 1):11-31.
4. Mathias A, Moss AJ, McNitt S, et al. Clinical implications of complete left-sided reverse remodeling with cardiac resynchronization therapy: A MADIT-CRT Substudy. J Am Coll Cardiol. 2016;68(12):1268-1276.