Neuroprotective Effects of Female Sex Steroids in Humans: Current Controversies and Future Directions

Overview

Journal Cell Mol Life Sci

Publisher Springer

Specialty Biology

Date 2005 Feb 22

PMID 15723166

Citations 18

Authors

C E Gleason

B Cholerton

C M Carlsson

S C Johnson

S Asthana

Affiliations

Soon will be listed here.

Abstract

Recent findings from the Women's Health Initiative (WHI) have raised considerable concern over prolonged use of opposed and unopposed oral conjugated equine estrogen (CEE), given the increased risk of serious adverse effects, including stroke and venous thromboembolic complications. Furthermore, results from the WHI Memory Study (WHIMS) indicated that over 5 years of therapy with Prempro impaired performance on global cognitive tests and nearly doubled the risk of dementia. These surprising findings were contradictory to cumulative evidence from basic science, epidemiological and some intervention studies suggesting hormone therapy was cardioprotective and could potentially reduce the risk of dementia. This review paper focuses on the neurobiology of estrogen, summarizing the clinical evidence for neuroprotective and cognition-enhancing efficacy of estrogen. Further, the paper briefly discusses variables that may account for the unexpected findings of WHIMS, and offers suggestions for future research.

Citing Articles

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References

Casselman F, Martens S, De Bruyne B, Degrieck I . Reducing operative mortality in valvular reoperations: the "valve in ring" procedure. J Thorac Cardiovasc Surg. 2010; 141(5):1317-8. DOI: 10.1016/j.jtcvs.2010.07.079. View

Lancellotti P, Tribouilloy C, Hagendorff A, Popescu B, Edvardsen T, Pierard L . Recommendations for the echocardiographic assessment of native valvular regurgitation: an executive summary from the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. 2013; 14(7):611-44. DOI: 10.1093/ehjci/jet105. View

Alsidawi S, Eleid M, Rihal C, Nkomo V, Pislaru S . Significant LVOT obstruction after mitral valve in ring procedure. Eur Heart J Cardiovasc Imaging. 2015; 16(12):1389. DOI: 10.1093/ehjci/jev235. View

Vahanian A, Alfieri O, Andreotti F, Antunes M, Baron-Esquivias G, Baumgartner H . Guidelines on the management of valvular heart disease (version 2012): the Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur J Cardiothorac Surg. 2012; 42(4):S1-44. DOI: 10.1093/ejcts/ezs455. View

Noack T, Mukherjee C, Kiefer P, Emrich F, Vollroth M, Ionasec R . Four-dimensional modelling of the mitral valve by real-time 3D transoesophageal echocardiography: proof of concept. Interact Cardiovasc Thorac Surg. 2014; 20(2):200-8. DOI: 10.1093/icvts/ivu357. View

Seeburger J, Borger M, Falk V, Kuntze T, Czesla M, Walther T . Minimal invasive mitral valve repair for mitral regurgitation: results of 1339 consecutive patients. Eur J Cardiothorac Surg. 2008; 34(4):760-5. DOI: 10.1016/j.ejcts.2008.05.015. View

Perier P, Hohenberger W, Lakew F, Batz G, Diegeler A . Rate of repair in minimally invasive mitral valve surgery. Ann Cardiothorac Surg. 2013; 2(6):751-7. PMC: 3856999. DOI: 10.3978/j.issn.2225-319X.2013.10.12. View

Acker M, Parides M, Perrault L, Moskowitz A, Gelijns A, Voisine P . Mitral-valve repair versus replacement for severe ischemic mitral regurgitation. N Engl J Med. 2013; 370(1):23-32. PMC: 4128011. DOI: 10.1056/NEJMoa1312808. View

Vassileva C, Boley T, Markwell S, Hazelrigg S . Impact of hospital annual mitral procedural volume on mitral valve repair rates and mortality. J Heart Valve Dis. 2012; 21(1):41-7. View

10.

Vassileva C, Mishkel G, McNeely C, Boley T, Markwell S, Scaife S . Long-term survival of patients undergoing mitral valve repair and replacement: a longitudinal analysis of Medicare fee-for-service beneficiaries. Circulation. 2013; 127(18):1870-6. DOI: 10.1161/CIRCULATIONAHA.113.002200. View

11.

Jassar A, Brinster C, Vergnat M, Robb J, Eperjesi T, Pouch A . Quantitative mitral valve modeling using real-time three-dimensional echocardiography: technique and repeatability. Ann Thorac Surg. 2010; 91(1):165-71. PMC: 3021252. DOI: 10.1016/j.athoracsur.2010.10.034. View

12.

David T, Armstrong S, McCrindle B, Manlhiot C . Late outcomes of mitral valve repair for mitral regurgitation due to degenerative disease. Circulation. 2013; 127(14):1485-92. DOI: 10.1161/CIRCULATIONAHA.112.000699. View

13.

Wilbring M, Alexiou K, Tugtekin S, Arzt S, Ibrahim K, Matschke K . Pushing the limits-further evolutions of transcatheter valve procedures in the mitral position, including valve-in-valve, valve-in-ring, and valve-in-native-ring. J Thorac Cardiovasc Surg. 2013; 147(1):210-9. DOI: 10.1016/j.jtcvs.2013.09.021. View

14.

Allende R, Doyle D, Urena M, B Ribeiro H, Amat-Santos I, Bernier M . Transcatheter mitral "valve-in-ring" implantation: a word of caution. Ann Thorac Surg. 2015; 99(4):1439-42. DOI: 10.1016/j.athoracsur.2014.06.083. View

15.

Vassileva C, McNeely C, Spertus J, Markwell S, Hazelrigg S . Hospital volume, mitral repair rates, and mortality in mitral valve surgery in the elderly: an analysis of US hospitals treating Medicare fee-for-service patients. J Thorac Cardiovasc Surg. 2014; 149(3):762-8.e1. DOI: 10.1016/j.jtcvs.2014.08.084. View

16.

De Bonis M, Al-Attar N, Antunes M, Borger M, Casselman F, Falk V . Surgical and interventional management of mitral valve regurgitation: a position statement from the European Society of Cardiology Working Groups on Cardiovascular Surgery and Valvular Heart Disease. Eur Heart J. 2015; 37(2):133-9. DOI: 10.1093/eurheartj/ehv322. View

17.

Gillinov A, Blackstone E, Nowicki E, Slisatkorn W, Al-Dossari G, Johnston D . Valve repair versus valve replacement for degenerative mitral valve disease. J Thorac Cardiovasc Surg. 2008; 135(4):885-93, 893.e1-2. DOI: 10.1016/j.jtcvs.2007.11.039. View

18.

Ionasec R, Voigt I, Georgescu B, Wang Y, Houle H, Vega-Higuera F . Patient-specific modeling and quantification of the aortic and mitral valves from 4-D cardiac CT and TEE. IEEE Trans Med Imaging. 2010; 29(9):1636-51. DOI: 10.1109/TMI.2010.2048756. View

19.

DiBardino D, ElBardissi A, McClure R, Razo-Vasquez O, Kelly N, Cohn L . Four decades of experience with mitral valve repair: analysis of differential indications, technical evolution, and long-term outcome. J Thorac Cardiovasc Surg. 2009; 139(1):76-83. DOI: 10.1016/j.jtcvs.2009.08.058. View

20.

Seeburger J, Falk V, Borger M, Passage J, Walther T, Doll N . Chordae replacement versus resection for repair of isolated posterior mitral leaflet prolapse: à ègalité. Ann Thorac Surg. 2009; 87(6):1715-20. DOI: 10.1016/j.athoracsur.2009.03.003. View