P3457Oxidative stress and left ventricular remodeling in postmenopausal women

Abstract

Abstract Purpose To asses the level of oxidative stress in postmenopausal women in dependence of LV structural and functional changes and its filling parameters. Methods 203 postmenopausal women were included in the investigation: 142 women with surgical menopause (average age 44,3±5,4 years, menopause duration 3,8±2,4 years); and 61 women with natural menopause (average age 46,2±4,7 years, menopause duration 4,3±2,1 years). All patients underwent general clinical examination, menopausal index evaluation, ambulatory blood pressure (BP) monitoring (Cardiotens-01, Meditech, Hungary), echocardiographic examination with systolic and diastolic left ventricular (LV) function assessment. We also measured erythrocyte thiobarbituric acid reactive substances (TBARs), ultimate products of lipid peroxidation (Shiff bases), catalase activity and plasma general antioxidant activity. Control group consisted of 35 healthy menstruating women (mean age 39,2±4,2). Statistical methods such as Cruskell-Walles criteria and χ2 test were used. Results Only 39 postmenopausal women (19,2%) had normal LV geometry; 89 pts (43,8%) demonstrated LV concentric hypertrophy, 57 pts (28,1%) – concentric remodeling and 18 women (8,9%) –eccentric hypertrophy. All postmenopausal women showed signs of activation of oxidative stress while reducing the power of antioxidant protection systems, however, these changes were most pronounced in groups of patients with eccentric and especially concentric LV hypertrophy Nobody of included postmenopausal women had LV systolic function failure. Presence of LV diastolic function disturbance was the same in the patients with surgical and natural menopause (54,1% (33 pts) and 59,1% (84 pts), respectively, p=0,231) and did not depend on BP level: 59,1% (52 pts) in hypertensive and 56,5% (65 pts) in normotensive women, p=0,118. We detected that Shiff bases level in postmenopausal women with diastolic dysfunction was increased in 1,5 times in comparison with healthy menstruating women and in 1,3 times in comparison with those postmenopausal women who had no diastolic function disturbance (p<0,01). The level of erythrocyte TBARs in this group was increased in 1,3 and 1,2 times respectively (p<0,05). Erythrocyte catalase activity and plasma general antioxidant activity were decreased in all postmenopausal women in comparison with healthy ones (p<0,01). The presence of LV diastolic dysfunction correlated positively with erythrocyte Shiff bases level (τ=0,47, p<0,01) and negatively – with erythrocyte catalase activity and plasma general antioxidant activity (τ=−0,35 and τ=−0,35, p<0,01 respectively) Conclusions Thus, oxidative stress may play important role in left ventricular remodeling and diastolic dysfunction formation in postmenopausal women.