The University of Southampton
University of Southampton Institutional Repository

The impact of menopausal hormone therapy (MHT) on cardiac structure and function: insights from the UK Biobank imaging enhancement study

The impact of menopausal hormone therapy (MHT) on cardiac structure and function: insights from the UK Biobank imaging enhancement study
The impact of menopausal hormone therapy (MHT) on cardiac structure and function: insights from the UK Biobank imaging enhancement study
Background: the effect of menopausal hormone therapy (MHT)–previously known as hormone replacement therapy–on cardiovascular health remains unclear and controversial. This cross-sectional study examined the impact of MHT on left ventricular (LV) and left atrial (LA) structure and function, alterations in which are markers of subclinical cardiovascular disease, in a population-based cohort.

Methods: post-menopausal women who had never used MHT and those who had used MHT ≥3 years participating in the UK Biobank who had undergone cardiovascular magnetic resonance (CMR) imaging and free of known cardiovascular disease were included. Multivariable linear regression was performed to examine the relationship between cardiac parameters and MHT use ≥3 years. To explore whether MHT use on each of the cardiac outcomes differed by age, multivariable regression models were constructed with a cross-product of age and MHT fitted as an interaction term.

Results: of 1604 post-menopausal women, 513 (32%) had used MHT ≥3 years. In the MHT cohort, median age at menopause was 50 (IQR: 45–52) and median duration of MHT was 8 years. In the non-MHT cohort, median age at menopause was 51 (IQR: 48–53). MHT use was associated with significantly lower LV end-diastolic volume (122.8 ml vs 119.8 ml, effect size = -2.4%, 95% CI: -4.2% to -0.5%; p = 0.013) and LA maximal volume (60.2 ml vs 57.5 ml, effect size = -4.5%, 95% CI: -7.8% to -1.0%; p = 0.012). There was no significant difference in LV mass. MHT use significantly modified the effect between age and CMR parameters; MHT users had greater decrements in LV end-diastolic volume, LV end-systolic volume and LA maximal volume with advancing age.

Conclusions: MHT use was not associated with adverse, subclinical changes in cardiac structure and function. Indeed, significantly smaller LV and LA chamber volumes were observed which have been linked to favourable cardiovascular outcomes. These findings represent a novel approach to examining MHT’s effect on the cardiovascular system.
1932-6203
Sanghvi, M.M.
1acf4acb-ec1f-45b3-adec-e9c5e8181bc2
Aung, N.
881def9c-fdd1-4aab-95bc-7a60dc6ef4db
Cooper, J.A.
0aa1c44c-3784-4a17-a0d6-3dc7fa75ae55
Paiva, J.M.
9d6ffe90-4d71-44b3-82d2-733e37fd8ddf
Lee, A.M.
b7a05220-1c96-4bf4-b1e2-8e03b1041823
Zemrak, F.
16581123-3977-46d2-b187-630977598fd9
Fung, K.
34abac9b-8c14-418a-8aca-5351df768a96
Thompson, R.J.
49ef1427-c727-4426-8d1b-6b32e84fa20d
Lukasachuk, E.
c4bf6ff0-a558-4c9b-80e4-9d47a55c690e
Carapella, V.
be5fa10f-73b0-4636-9a42-0b6c28f6ce84
Kim, Y.J.
17440d86-a06c-4287-99e8-9286e8fad906
Harvey, Nicholas
ce487fb4-d360-4aac-9d17-9466d6cba145
Piechnik, S.K.
a62ec277-6d0d-4d9b-9301-eab58e291688
Neubauer, Stefan
c8a34156-a4ed-4dfe-97cb-4f47627d927d
Petersen, Steffen E.
04f2ce88-790d-48dc-baac-cbe0946dd928
Sanghvi, M.M.
1acf4acb-ec1f-45b3-adec-e9c5e8181bc2
Aung, N.
881def9c-fdd1-4aab-95bc-7a60dc6ef4db
Cooper, J.A.
0aa1c44c-3784-4a17-a0d6-3dc7fa75ae55
Paiva, J.M.
9d6ffe90-4d71-44b3-82d2-733e37fd8ddf
Lee, A.M.
b7a05220-1c96-4bf4-b1e2-8e03b1041823
Zemrak, F.
16581123-3977-46d2-b187-630977598fd9
Fung, K.
34abac9b-8c14-418a-8aca-5351df768a96
Thompson, R.J.
49ef1427-c727-4426-8d1b-6b32e84fa20d
Lukasachuk, E.
c4bf6ff0-a558-4c9b-80e4-9d47a55c690e
Carapella, V.
be5fa10f-73b0-4636-9a42-0b6c28f6ce84
Kim, Y.J.
17440d86-a06c-4287-99e8-9286e8fad906
Harvey, Nicholas
ce487fb4-d360-4aac-9d17-9466d6cba145
Piechnik, S.K.
a62ec277-6d0d-4d9b-9301-eab58e291688
Neubauer, Stefan
c8a34156-a4ed-4dfe-97cb-4f47627d927d
Petersen, Steffen E.
04f2ce88-790d-48dc-baac-cbe0946dd928

Sanghvi, M.M., Aung, N., Cooper, J.A., Paiva, J.M., Lee, A.M., Zemrak, F., Fung, K., Thompson, R.J., Lukasachuk, E., Carapella, V., Kim, Y.J., Harvey, Nicholas, Piechnik, S.K., Neubauer, Stefan and Petersen, Steffen E. (2018) The impact of menopausal hormone therapy (MHT) on cardiac structure and function: insights from the UK Biobank imaging enhancement study. PLoS ONE, 13 (3). (doi:10.1371/journal.pone.0194015).

Record type: Article

Abstract

Background: the effect of menopausal hormone therapy (MHT)–previously known as hormone replacement therapy–on cardiovascular health remains unclear and controversial. This cross-sectional study examined the impact of MHT on left ventricular (LV) and left atrial (LA) structure and function, alterations in which are markers of subclinical cardiovascular disease, in a population-based cohort.

Methods: post-menopausal women who had never used MHT and those who had used MHT ≥3 years participating in the UK Biobank who had undergone cardiovascular magnetic resonance (CMR) imaging and free of known cardiovascular disease were included. Multivariable linear regression was performed to examine the relationship between cardiac parameters and MHT use ≥3 years. To explore whether MHT use on each of the cardiac outcomes differed by age, multivariable regression models were constructed with a cross-product of age and MHT fitted as an interaction term.

Results: of 1604 post-menopausal women, 513 (32%) had used MHT ≥3 years. In the MHT cohort, median age at menopause was 50 (IQR: 45–52) and median duration of MHT was 8 years. In the non-MHT cohort, median age at menopause was 51 (IQR: 48–53). MHT use was associated with significantly lower LV end-diastolic volume (122.8 ml vs 119.8 ml, effect size = -2.4%, 95% CI: -4.2% to -0.5%; p = 0.013) and LA maximal volume (60.2 ml vs 57.5 ml, effect size = -4.5%, 95% CI: -7.8% to -1.0%; p = 0.012). There was no significant difference in LV mass. MHT use significantly modified the effect between age and CMR parameters; MHT users had greater decrements in LV end-diastolic volume, LV end-systolic volume and LA maximal volume with advancing age.

Conclusions: MHT use was not associated with adverse, subclinical changes in cardiac structure and function. Indeed, significantly smaller LV and LA chamber volumes were observed which have been linked to favourable cardiovascular outcomes. These findings represent a novel approach to examining MHT’s effect on the cardiovascular system.

Text
PONE-D-17-34219_R2 - Accepted Manuscript
Restricted to Repository staff only
Request a copy
Text
MHT - Version of Record
Available under License Creative Commons Attribution.
Download (1MB)

More information

Accepted/In Press date: 22 February 2018
e-pub ahead of print date: 8 March 2018

Identifiers

Local EPrints ID: 418799
URI: https://eprints.soton.ac.uk/id/eprint/418799
ISSN: 1932-6203
PURE UUID: 4d0887b9-199e-4d69-990e-832a505946e8
ORCID for Nicholas Harvey: ORCID iD orcid.org/0000-0002-8194-2512

Catalogue record

Date deposited: 22 Mar 2018 17:30
Last modified: 10 Dec 2019 01:45

Export record

Altmetrics

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of https://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×