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

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journal contribution
posted on 04.03.2020, 15:15 by Emma ODonnellEmma ODonnell, Jack M Goodman, John S Floras, Paula J Harvey
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/m2), 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 wave form 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 one‐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<0.05) and TPR higher (p<0.05) in ExFHA. Post‐exercise, AIx75 was unchanged (p>0.05) in ExFHA but was lowered (p<0.05) in ExOv. Both groups demonstrated increased CO, and lowered SBPc and TPR, yet TPR remained higher (p<0.05), and CO and SBPc lower (p<0.05) in ExFHA.

Conclusions
Despite hypoestrogenemia, functional compliance of the central arteries and central BP are 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.

Funding

Pfizer Cardiovascular Independent Research Award (NRA 3840028)

History

School

  • Sport, Exercise and Health Sciences

Published in

Scandinavian Journal of Medicine & Science in Sports

Volume

30

Issue

6

Pages

1054 - 1063

Publisher

John Wiley & Sons Ltd

Version

AM (Accepted Manuscript)

Rights holder

© John Wiley & Sons A/S

Publisher statement

This is the peer reviewed version of the following article: O'DONNELL, E. ... et al, 2020. Indexes of aortic wave reflection are not augmented in estrogen-deficient physically active premenopausal women. Scandinavian Journal of Medicine & Science in Sports, 30 (6), pp.1054-1063, which has been published in final form at https://doi.org/10.1111/sms.13647. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.

Acceptance date

17/02/2020

Publication date

2020-03-02

Copyright date

2020

ISSN

0905-7188

eISSN

1600-0838

Language

en

Depositor

Dr Emma O'Donnell. Deposit date: 4 March 2020

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