Effects of hormone replacement therapy on left ventricular diastolic function in postmenopausal women: a systematic review and meta-analysis

Abstract

Background

Postmenopausal women tend to experience significant changes in left ventricular diastolic function (LVDF). However, there are conflicting reports about LVDF between postmenopausal women on hormone replacement therapy (HRT) and those not on HRT. This meta-analysis is to evaluate the effects of HRT on LVDF in postmenopausal women.

Methods

We conducted a systemic review of randomized controlled trials published up to December 31 2019 using Embase, Pubmed, and the Cochrane library database.

Results

Eight studies involving 668 postmenopausal women were identified. Our analysis indicated that the ratio of the peak velocity during early filing to late filling from atrial contraction improvement in HRT group was better than that in placebo group (MD 0.20, 95%CI 0.12 to 0.28). There was a significant reduction in deceleration time and left ventricular mass index in HRT group compared with placebo group (MD −21.01, 95%CI −40.11 to −1.91 vs MD −8.26, 95%CI −14.10 to −2.42). No significant difference was observed in left ventricular end systole diameter (MD 0.80, 95%CI −0.72 to 2.31), left ventricular end diastole diameter (MD −0.07, 95%CI −1.25 to 1.10), left atrial size (MD −0.33, 95%CI −1.34 to 0.68)and the isovolumic relaxation time (MD −12.08, 95%CI −27.65 to 3.5).

Conclusions

Our meta-analysis illustrated that postmenopausal women seem to obtain more beneficial effects from HRT on LVDF, though future studies are required to elucidate the specific mechanisms for this phenomenon.

摘要

背景：绝经后女性的左室舒张功能（left ventricular diastolic function, LVDF）有明显改变。然而, 关于有无激素替代治疗（hormone replacement therapy, HRT）的绝经后女性LVDF的报道存在矛盾。本meta分析旨在评价HRT对绝经后女性LVDF的影响。方法：我们用Embase、Pubmed和Cochrane图书馆数据库对截至2019年12月31日发表的随机对照试验进行了系统回顾。结果：纳入8项研究, 共涉及668名绝经后女性。我们的分析表明, 心房收缩改善后HRT组早期充盈与晚期充盈的峰值速度之比优于安慰剂组(MD 0.20, 95%CI 0.12∼ 0.28)。与安慰剂组相比, HRT组的减速时间和左心室重量指数显著减少(MD -21.01, 95%CI -40.11 ∼ -1.91 vs MD -8.26, 95%CI -14.10 ∼ -2.42)。左室收缩末期内径(MD 0.80, 95%CI -0.72 ∼ 2.31)

、左室舒张末期内径(MD -0.07, 95%CI -1.25 ∼ 1.10)、左房内径(MD -0.33, 95%CI -1.34 ∼ 0.68)

和等容舒张时间(MD -12.08, 95%CI -27.65∼3.5)无显著性差异。结论：我们的meta分析表明, HRT似乎可以改善绝经后女性的LVDF, 但仍需进一步研究阐明其具体机制。

Keywords:

• Postmenopausal women
• hormone replacement therapy
• diastolic function
• meta-analysis

Acknowledgements

The authors would like to thank Dr Qiong-yin Wang for her critical English editing.

Authors’ contributions

YJ substantially contributed to study concept, design and results interpretation. JC and YM contributed equally to this article. All authors read and approved the final manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Available data and materials are included in this manuscript.

Additional information

Funding

This study was supported by the National Natural Science Foundation of China [NSFC 81960086].