Estrogen Contributions to Microvascular Dysfunction Evolving to Heart Failure With Preserved Ejection Fraction
Heart failure with preserved ejection fraction (HFpEF) is a syndrome involving microvascular dysfunction. No treatment is available yet and as the HFpEF patient group is expanding due to the aging population, more knowledge on dysfunction of the cardiac microvasculature is required. Endothelial dysf...
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2019-07-01
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doaj-e33e5149b3b44f6b912c991de2714dd22020-11-24T21:27:59ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922019-07-011010.3389/fendo.2019.00442457736Estrogen Contributions to Microvascular Dysfunction Evolving to Heart Failure With Preserved Ejection FractionAriane A. SickingheSuzanne J. A. KorporaalHester M. den RuijterElise L. KesslerHeart failure with preserved ejection fraction (HFpEF) is a syndrome involving microvascular dysfunction. No treatment is available yet and as the HFpEF patient group is expanding due to the aging population, more knowledge on dysfunction of the cardiac microvasculature is required. Endothelial dysfunction, impaired angiogenesis, (perivascular) fibrosis and the pruning of capillaries (rarefaction) may all contribute to microvascular dysfunction in the heart and other organs, e.g., the kidneys. The HFpEF patient group consists mainly of post-menopausal women and female sex itself is a risk factor for this syndrome. This may point toward a role of estrogen depletion after menopause in the development of HFpEF. Estrogens favor the ratio of vasodilating over vasoconstricting factors, which results in an overall lower blood pressure in women than in men. Furthermore, estrogens improve angiogenic capacity and attenuate (perivascular) fibrosis formation. Therefore, we hypothesize that the drop of estrogen levels after menopause contributes to myocardial microvascular dysfunction and renders post-menopausal women more vulnerable for heart diseases that involve the microvasculature. This review provides a detailed summary of molecular targets of estrogen, which might guide future research and treatment options.https://www.frontiersin.org/article/10.3389/fendo.2019.00442/fullheart failure with preserved ejection fractionmicrovascular dysfunctionsex differencesestrogensendothelial dysfunctionimpaired angiogenesis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ariane A. Sickinghe Suzanne J. A. Korporaal Hester M. den Ruijter Elise L. Kessler |
spellingShingle |
Ariane A. Sickinghe Suzanne J. A. Korporaal Hester M. den Ruijter Elise L. Kessler Estrogen Contributions to Microvascular Dysfunction Evolving to Heart Failure With Preserved Ejection Fraction Frontiers in Endocrinology heart failure with preserved ejection fraction microvascular dysfunction sex differences estrogens endothelial dysfunction impaired angiogenesis |
author_facet |
Ariane A. Sickinghe Suzanne J. A. Korporaal Hester M. den Ruijter Elise L. Kessler |
author_sort |
Ariane A. Sickinghe |
title |
Estrogen Contributions to Microvascular Dysfunction Evolving to Heart Failure With Preserved Ejection Fraction |
title_short |
Estrogen Contributions to Microvascular Dysfunction Evolving to Heart Failure With Preserved Ejection Fraction |
title_full |
Estrogen Contributions to Microvascular Dysfunction Evolving to Heart Failure With Preserved Ejection Fraction |
title_fullStr |
Estrogen Contributions to Microvascular Dysfunction Evolving to Heart Failure With Preserved Ejection Fraction |
title_full_unstemmed |
Estrogen Contributions to Microvascular Dysfunction Evolving to Heart Failure With Preserved Ejection Fraction |
title_sort |
estrogen contributions to microvascular dysfunction evolving to heart failure with preserved ejection fraction |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Endocrinology |
issn |
1664-2392 |
publishDate |
2019-07-01 |
description |
Heart failure with preserved ejection fraction (HFpEF) is a syndrome involving microvascular dysfunction. No treatment is available yet and as the HFpEF patient group is expanding due to the aging population, more knowledge on dysfunction of the cardiac microvasculature is required. Endothelial dysfunction, impaired angiogenesis, (perivascular) fibrosis and the pruning of capillaries (rarefaction) may all contribute to microvascular dysfunction in the heart and other organs, e.g., the kidneys. The HFpEF patient group consists mainly of post-menopausal women and female sex itself is a risk factor for this syndrome. This may point toward a role of estrogen depletion after menopause in the development of HFpEF. Estrogens favor the ratio of vasodilating over vasoconstricting factors, which results in an overall lower blood pressure in women than in men. Furthermore, estrogens improve angiogenic capacity and attenuate (perivascular) fibrosis formation. Therefore, we hypothesize that the drop of estrogen levels after menopause contributes to myocardial microvascular dysfunction and renders post-menopausal women more vulnerable for heart diseases that involve the microvasculature. This review provides a detailed summary of molecular targets of estrogen, which might guide future research and treatment options. |
topic |
heart failure with preserved ejection fraction microvascular dysfunction sex differences estrogens endothelial dysfunction impaired angiogenesis |
url |
https://www.frontiersin.org/article/10.3389/fendo.2019.00442/full |
work_keys_str_mv |
AT arianeasickinghe estrogencontributionstomicrovasculardysfunctionevolvingtoheartfailurewithpreservedejectionfraction AT suzannejakorporaal estrogencontributionstomicrovasculardysfunctionevolvingtoheartfailurewithpreservedejectionfraction AT hestermdenruijter estrogencontributionstomicrovasculardysfunctionevolvingtoheartfailurewithpreservedejectionfraction AT eliselkessler estrogencontributionstomicrovasculardysfunctionevolvingtoheartfailurewithpreservedejectionfraction |
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