РОЛЬ ЭСТРОГЕНОВ В ВЕГЕТАТИВНОЙ РЕГУЛЯЦИИ СЕРДЕЧНО-СОСУДИСТОЙ СИСТЕМЫ В МЕНОПАУЗЕ

Abstract

Hot flashes are known to be associated with a variety of cardiovascular risk factors. There is evidence of a close relationship between hot flashes and autonomic dysfunction, while the parameter - heart rate variability (HRV) - is a surrogate marker for assessing the activity of the autonomic nervous system (ANS). However, changes in HRV can be caused by both aging and hormonal changes. The purpose of this work is to consider the role of endogenous estrogens in the autonomic regulation of the cardiovascular system on the model of "acute estrogen deficiency" in cases of total oophorectomy and "partial estrogen deficiency" - in cases of hysterectomy with / without appendages. 44 women were included, mean age - 46.9 ± 2.2 years, whose HRV was assessed before surgery (1 week before surgery) and after (not less than 4 and not more than 5 weeks after surgery). According to the results obtained, there were no statistically significant changes in both temporal and spectral HRV parameters in patients after hysterectomy (p> 0.05). On the contrary, patients with total oophorectomy in the postoperative period showed decreased HRV parameters characterizing the parasympathetic activity of the ANS, namely SDRR, rMSSD, pNN50, HF and the LF index, reflecting both sympathetic and parasympathetic effects on heart rate. Patients with total oophorectomy have a higher ratio of the sympatovagal LF / HF index; the work shows that this fact is most likely due to the predominance of sympathetic nervous influences induced by "acute" withdrawal of ovarian hormones due to the performed volume of surgery, and not as a result of surgery. as such, or its psychological consequences. Thus, according to the above-described results of the study, patients in cases of total oophorectomy showed a decrease in the parameters of vagal HRV in the direction of sympathetic dominance, which may cause an increase in cardiovascular risk.