P393Left ventricular remodeling in postmenopausal women.


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Abstract

Purpose: To asses structural and functional changes of left ventricle in postmenopausal women.Methods: 203 postmenopausal women were included in the investigation: the 1st group – 142 women with surgical menopause (average age 44,3±5,4 years, menopause duration 3,8±2,4 years); and the 2nd group – 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. Statistical methods such as Cruskell-Walles criteria and χ2test were used.Results: Arterial hypertension frequency in women with natural and surgical menopause was the same: 45,9% (28 pts) in the 1st group and 42,3% (60 pts) in the 2nd group, respectively (p>0,05). 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. The frequency of LV concentric hypertrophy in the 1st group was wider than in the 2nd group (47,9% (68 pts) vs 24,4% (21pts), p=0,049); while women of the 2nd group more often had LV eccentric hypertrophy (19,7% (12 pts) vs 4,9% (7 pts), p=0,0002) and normal geometry (26,2% (16 pts) vs 15,5% (22 pts), p=0,0017). Hypertensive postmenopausal women more often had LV concentric hypertrophy (60,2% (53 pts)vs 31,3% (36 pts) in normotensive women, p=0,005) while normotensive postmenopausal women more often demonstrated LV concentric remodeling (33,9%(39 pts)vs 20,5% (18 pts), p=0,042) and LV normal geometry (23,5% (27 pts) vs12,5% (11 pts), p=0,034). Nobody of included postmenopausal women had LV systolic function failure. Presence of LV diastolic function disturbance was the same in the 1st and in the2nd groups (56,8% (50 pts) and 59,2 (84 pts), respectively, p=0,231) and did not depend on BP level: 56,8% (50 pts) in hypertensive and 59,1% (68pts) in normotensive women, p=0,118. Patients with LV concentric hypertrophy had LV diastolic dysfunction in 84,3% cases (75 pts); with LV concentric remodeling – in 52,6% cases (30 pts)< with LV eccentric hypertrophy – in 31,6% cases (6 pts), this difference was statistically significant.Conclusions: LV remodeling regularities in postmenopausal women depend on menopausetype and BP level. LV diastolic function evolution for the most part depends on LV remodeling type, but not on menopause type or arterial hypertension presence.

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