Sex Hormones Are Associated with Right Ventricular Structure and Function: The MESA-right Ventricle Study

Overview

Journal Am J Respir Crit Care Med

Specialty Critical Care

Date 2010 Oct 5

PMID 20889903

Citations 99

Authors

Corey E Ventetuolo

Pamela Ouyang

David A Bluemke

Harikrishna Tandri

R Graham Barr

Emilia Bagiella

Anne R Cappola

Michael R Bristow

Craig Johnson

Richard A Kronmal

Jorge R Kizer

Joao A C Lima

Steven M Kawut

Affiliations

Soon will be listed here.

Abstract

Rationale: Sex hormones have effects on the left ventricle, but hormonal influences on the right ventricle (RV) are unknown.

Objectives: We hypothesized that sex hormones would be associated with RV morphology in a large cohort free of cardiovascular disease.

Methods: Sex hormones were measured by immunoassay and RV ejection fraction (RVEF), stroke volume (RVSV), mass, end-diastolic volume, and end-systolic volume (RVESV) were measured by cardiac magnetic resonance imaging in 1,957 men and 1,738 postmenopausal women. The relationship between each hormone and RV parameter was assessed by multivariate linear regression.

Measurements And Main Results: Higher estradiol levels were associated with higher RVEF (β per 1 ln[nmol/L], 0.88; 95% confidence interval [CI], 0.32 to 1.43; P = 0.002) and lower RVESV (β per 1 ln[nmol/L], -0.87; 95% CI, -1.67 to -0.08; P = 0.03) in women using hormone therapy. In men, higher bioavailable testosterone levels were associated with higher RVSV (β per 1 ln[nmol/L], 1.97; 95% CI, 0.20 to 3.73; P = 0.03) and greater RV mass and volumes (P ≤ 0.01). Higher dehydroepiandrosterone levels were associated with higher RVSV (β per 1 ln[nmol/L], 1.37; 95% CI, 0.15 to 2.59; P = 0.03) and greater RV mass (β per 1 ln[nmol/L], 0.25; 95% CI, 0.00 to 0.49; P = 0.05) and volumes (P ≤ 0.001) in women.

Conclusions: Higher estradiol levels were associated with better RV systolic function in women using hormone therapy. Higher levels of androgens were associated with greater RV mass and volumes in both sexes.

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References

Chahal H, Johnson C, Tandri H, Jain A, Hundley W, Barr R . Relation of cardiovascular risk factors to right ventricular structure and function as determined by magnetic resonance imaging (results from the multi-ethnic study of atherosclerosis). Am J Cardiol. 2010; 106(1):110-6. PMC: 2901248. DOI: 10.1016/j.amjcard.2010.02.022. View

Barst R, Rubin L, Long W, McGoon M, Rich S, Badesch D . A comparison of continuous intravenous epoprostenol (prostacyclin) with conventional therapy for primary pulmonary hypertension. N Engl J Med. 1996; 334(5):296-301. DOI: 10.1056/NEJM199602013340504. View

Resta T, Kanagy N, Walker B . Estradiol-induced attenuation of pulmonary hypertension is not associated with altered eNOS expression. Am J Physiol Lung Cell Mol Physiol. 2001; 280(1):L88-97. DOI: 10.1152/ajplung.2001.280.1.L88. View

Heckbert S, Post W, Pearson G, Arnett D, Gomes A, Jerosch-Herold M . Traditional cardiovascular risk factors in relation to left ventricular mass, volume, and systolic function by cardiac magnetic resonance imaging: the Multiethnic Study of Atherosclerosis. J Am Coll Cardiol. 2006; 48(11):2285-92. PMC: 1794681. DOI: 10.1016/j.jacc.2006.03.072. View

Aaron C, Tandri H, Barr R, Johnson W, Bagiella E, Chahal H . Physical activity and right ventricular structure and function. The MESA-Right Ventricle Study. Am J Respir Crit Care Med. 2010; 183(3):396-404. PMC: 3056232. DOI: 10.1164/rccm.201003-0469OC. View

Sodergard R, Backstrom T, Shanbhag V, Carstensen H . Calculation of free and bound fractions of testosterone and estradiol-17 beta to human plasma proteins at body temperature. J Steroid Biochem. 1982; 16(6):801-10. DOI: 10.1016/0022-4731(82)90038-3. View

Donaldson C, Eder S, Baker C, Aronovitz M, Weiss A, Hall-Porter M . Estrogen attenuates left ventricular and cardiomyocyte hypertrophy by an estrogen receptor-dependent pathway that increases calcineurin degradation. Circ Res. 2008; 104(2):265-75, 11p following 275. PMC: 4427027. DOI: 10.1161/CIRCRESAHA.108.190397. View

Rodriguez J, Jiang R, Johnson W, MacKenzie B, Smith L, Barr R . The association of pipe and cigar use with cotinine levels, lung function, and airflow obstruction: a cross-sectional study. Ann Intern Med. 2010; 152(4):201-10. PMC: 2906916. DOI: 10.7326/0003-4819-152-4-201002160-00004. View

Becchis M, Sullivan P, Ordronneau P, Petrusz P, Joseph D . Distribution of immunoreactive androgen-binding protein/sex hormone-binding globulin in tissues of the fetal rat. Steroids. 1996; 61(7):392-400. DOI: 10.1016/0039-128x(96)00049-9. View

10.

Ponikowska B, Jankowska E, Maj J, Wegrzynowska-Teodorczyk K, Biel B, Reczuch K . Gonadal and adrenal androgen deficiencies as independent predictors of increased cardiovascular mortality in men with type II diabetes mellitus and stable coronary artery disease. Int J Cardiol. 2009; 143(3):343-8. DOI: 10.1016/j.ijcard.2009.03.072. View

11.

Roeleveld R, Vonk-Noordegraaf A, Marcus J, Bronzwaer J, Marques K, Postmus P . Effects of epoprostenol on right ventricular hypertrophy and dilatation in pulmonary hypertension. Chest. 2004; 125(2):572-9. DOI: 10.1378/chest.125.2.572. View

12.

Ouyang P, Vaidya D, Dobs A, Golden S, Szklo M, Heckbert S . Sex hormone levels and subclinical atherosclerosis in postmenopausal women: the Multi-Ethnic Study of Atherosclerosis. Atherosclerosis. 2008; 204(1):255-61. PMC: 2729280. DOI: 10.1016/j.atherosclerosis.2008.08.037. View

13.

Giuberti K, Pereira R, Bianchi P, Paigel A, Vassallo D, Stefanon I . Influence of ovariectomy in the right ventricular contractility in heart failure rats. Arch Med Res. 2007; 38(2):170-5. DOI: 10.1016/j.arcmed.2006.09.015. View

14.

Grothues F, Moon J, Bellenger N, Smith G, Klein H, Pennell D . Interstudy reproducibility of right ventricular volumes, function, and mass with cardiovascular magnetic resonance. Am Heart J. 2004; 147(2):218-23. DOI: 10.1016/j.ahj.2003.10.005. View

15.

He J, Ogden L, Bazzano L, Vupputuri S, Loria C, Whelton P . Risk factors for congestive heart failure in US men and women: NHANES I epidemiologic follow-up study. Arch Intern Med. 2001; 161(7):996-1002. DOI: 10.1001/archinte.161.7.996. View

16.

Kawut S, Al-Naamani N, Agerstrand C, Rosenzweig E, Rowan C, Barst R . Determinants of right ventricular ejection fraction in pulmonary arterial hypertension. Chest. 2008; 135(3):752-759. PMC: 2834785. DOI: 10.1378/chest.08-1758. View

17.

Psaty B, Lee M, Savage P, Rutan G, German P, Lyles M . Assessing the use of medications in the elderly: methods and initial experience in the Cardiovascular Health Study. The Cardiovascular Health Study Collaborative Research Group. J Clin Epidemiol. 1992; 45(6):683-92. DOI: 10.1016/0895-4356(92)90143-b. View

18.

Iwakura A, Shastry S, Luedemann C, Hamada H, Kawamoto A, Kishore R . Estradiol enhances recovery after myocardial infarction by augmenting incorporation of bone marrow-derived endothelial progenitor cells into sites of ischemia-induced neovascularization via endothelial nitric oxide synthase-mediated activation of.... Circulation. 2006; 113(12):1605-14. DOI: 10.1161/CIRCULATIONAHA.105.553925. View

19.

Badesch D, Raskob G, Elliott C, Krichman A, Farber H, Frost A . Pulmonary arterial hypertension: baseline characteristics from the REVEAL Registry. Chest. 2009; 137(2):376-87. DOI: 10.1378/chest.09-1140. View

20.

Rowell K, Hall J, Pugh P, Jones T, Channer K, Jones R . Testosterone acts as an efficacious vasodilator in isolated human pulmonary arteries and veins: evidence for a biphasic effect at physiological and supra-physiological concentrations. J Endocrinol Invest. 2009; 32(9):718-23. DOI: 10.1007/BF03346526. View