Predominance of Heart Failure With Preserved Ejection Fraction in Postmenopausal Women: Intra- and Extra-Cardiomyocyte Maladaptive Alterations Scaffolded by Estrogen Deficiency
Heart failure (HF) remains a public health concern as it is associated with high morbidity and death rates. In particular, heart failure with preserved ejection fraction (HFpEF) represents the dominant (>50%) form of HF and mostly occurring among postmenopausal women. Hence, the initiation an...
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doaj-85ff26a617344a2e8cf99b27a2a977ed2021-09-29T06:04:50ZengFrontiers Media S.A.Frontiers in Cell and Developmental Biology2296-634X2021-09-01910.3389/fcell.2021.685996685996Predominance of Heart Failure With Preserved Ejection Fraction in Postmenopausal Women: Intra- and Extra-Cardiomyocyte Maladaptive Alterations Scaffolded by Estrogen DeficiencyAdebayo Oluwafemi Adekunle0Gabriel Komla Adzika1Richard Mprah2Marie Louise Ndzie Noah3Joseph Adu-Amankwaah4Ruqayya Rizvi5Nazma Akhter6Hong Sun7Hong Sun8Department of Physiology, Xuzhou Medical University, Xuzhou, ChinaDepartment of Physiology, Xuzhou Medical University, Xuzhou, ChinaDepartment of Physiology, Xuzhou Medical University, Xuzhou, ChinaDepartment of Physiology, Xuzhou Medical University, Xuzhou, ChinaDepartment of Physiology, Xuzhou Medical University, Xuzhou, ChinaXuzhou Medical University, Xuzhou, ChinaDepartment of Physiology, Xuzhou Medical University, Xuzhou, ChinaDepartment of Physiology, Xuzhou Medical University, Xuzhou, ChinaXuzhou Medical University, Xuzhou, ChinaHeart failure (HF) remains a public health concern as it is associated with high morbidity and death rates. In particular, heart failure with preserved ejection fraction (HFpEF) represents the dominant (>50%) form of HF and mostly occurring among postmenopausal women. Hence, the initiation and progression of the left ventricular diastolic dysfunctions (LVDD) (a typically clinical manifestation of HFpEF) in postmenopausal women have been attributed to estrogen deficiency and the loss of its residue cardioprotective effects. In this review, from a pathophysiological and immunological standpoint, we discuss the probable multiple pathomechanisms resulting in HFpEF, which are facilitated by estrogen deficiency. The initial discussions recap estrogen and estrogen receptors (ERs) and β-adrenergic receptors (βARs) signaling under physiological/pathological states to facilitate cardiac function/dysfunction, respectively. By reconciling these prior discussions, attempts were made to explain how the loss of estrogen facilitates the disruptions both ERs and βARs-mediated signaling responsible for; the modulation of intra-cardiomyocyte calcium homeostasis, maintenance of cardiomyocyte cytoskeletal and extracellular matrix, the adaptive regulation of coronary microvascular endothelial functions and myocardial inflammatory responses. By scaffolding the disruption of these crucial intra- and extra-cardiomyocyte physiological functions, estrogen deficiency has been demonstrated to cause LVDD and increase the incidence of HFpEF in postmenopausal women. Finally, updates on the advancements in treatment interventions for the prevention of HFpEF were highlighted.https://www.frontiersin.org/articles/10.3389/fcell.2021.685996/fullHFpEFestrogen deficiencyβ-adrenergic receptorscalcium handlingcardiomyocyte cytoskeletonextra cellular matrix |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Adebayo Oluwafemi Adekunle Gabriel Komla Adzika Richard Mprah Marie Louise Ndzie Noah Joseph Adu-Amankwaah Ruqayya Rizvi Nazma Akhter Hong Sun Hong Sun |
spellingShingle |
Adebayo Oluwafemi Adekunle Gabriel Komla Adzika Richard Mprah Marie Louise Ndzie Noah Joseph Adu-Amankwaah Ruqayya Rizvi Nazma Akhter Hong Sun Hong Sun Predominance of Heart Failure With Preserved Ejection Fraction in Postmenopausal Women: Intra- and Extra-Cardiomyocyte Maladaptive Alterations Scaffolded by Estrogen Deficiency Frontiers in Cell and Developmental Biology HFpEF estrogen deficiency β-adrenergic receptors calcium handling cardiomyocyte cytoskeleton extra cellular matrix |
author_facet |
Adebayo Oluwafemi Adekunle Gabriel Komla Adzika Richard Mprah Marie Louise Ndzie Noah Joseph Adu-Amankwaah Ruqayya Rizvi Nazma Akhter Hong Sun Hong Sun |
author_sort |
Adebayo Oluwafemi Adekunle |
title |
Predominance of Heart Failure With Preserved Ejection Fraction in Postmenopausal Women: Intra- and Extra-Cardiomyocyte Maladaptive Alterations Scaffolded by Estrogen Deficiency |
title_short |
Predominance of Heart Failure With Preserved Ejection Fraction in Postmenopausal Women: Intra- and Extra-Cardiomyocyte Maladaptive Alterations Scaffolded by Estrogen Deficiency |
title_full |
Predominance of Heart Failure With Preserved Ejection Fraction in Postmenopausal Women: Intra- and Extra-Cardiomyocyte Maladaptive Alterations Scaffolded by Estrogen Deficiency |
title_fullStr |
Predominance of Heart Failure With Preserved Ejection Fraction in Postmenopausal Women: Intra- and Extra-Cardiomyocyte Maladaptive Alterations Scaffolded by Estrogen Deficiency |
title_full_unstemmed |
Predominance of Heart Failure With Preserved Ejection Fraction in Postmenopausal Women: Intra- and Extra-Cardiomyocyte Maladaptive Alterations Scaffolded by Estrogen Deficiency |
title_sort |
predominance of heart failure with preserved ejection fraction in postmenopausal women: intra- and extra-cardiomyocyte maladaptive alterations scaffolded by estrogen deficiency |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Cell and Developmental Biology |
issn |
2296-634X |
publishDate |
2021-09-01 |
description |
Heart failure (HF) remains a public health concern as it is associated with high morbidity and death rates. In particular, heart failure with preserved ejection fraction (HFpEF) represents the dominant (>50%) form of HF and mostly occurring among postmenopausal women. Hence, the initiation and progression of the left ventricular diastolic dysfunctions (LVDD) (a typically clinical manifestation of HFpEF) in postmenopausal women have been attributed to estrogen deficiency and the loss of its residue cardioprotective effects. In this review, from a pathophysiological and immunological standpoint, we discuss the probable multiple pathomechanisms resulting in HFpEF, which are facilitated by estrogen deficiency. The initial discussions recap estrogen and estrogen receptors (ERs) and β-adrenergic receptors (βARs) signaling under physiological/pathological states to facilitate cardiac function/dysfunction, respectively. By reconciling these prior discussions, attempts were made to explain how the loss of estrogen facilitates the disruptions both ERs and βARs-mediated signaling responsible for; the modulation of intra-cardiomyocyte calcium homeostasis, maintenance of cardiomyocyte cytoskeletal and extracellular matrix, the adaptive regulation of coronary microvascular endothelial functions and myocardial inflammatory responses. By scaffolding the disruption of these crucial intra- and extra-cardiomyocyte physiological functions, estrogen deficiency has been demonstrated to cause LVDD and increase the incidence of HFpEF in postmenopausal women. Finally, updates on the advancements in treatment interventions for the prevention of HFpEF were highlighted. |
topic |
HFpEF estrogen deficiency β-adrenergic receptors calcium handling cardiomyocyte cytoskeleton extra cellular matrix |
url |
https://www.frontiersin.org/articles/10.3389/fcell.2021.685996/full |
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