PDF(Pubmed)
Abstract：
UNASSIGNED: Recent evidence has shown that reproductive factors are associated with an increased risk of heart failure with preserved ejection fraction in women. However, the pathogenic pathways underlying this relationship are unclear. Subclinical myocardial fibrosis has been found to be a common pathway in a large proportion of patients with heart failure with preserved ejection fraction.
UNASSIGNED: This study examined the relationship between vital reproductive factors (parity, pregnancy, age at menopause, and use of hormone replacement therapy [HRT]) with interstitial myocardial fibrosis (IMF) and myocardial scar measured by cardiac magnetic resonance imaging (CMR) T1 mapping and late gadolinium enhancement, respectively.
UNASSIGNED: There were 596 female participants (mean age 67 ± 8 years) enrolled in MESA (Multi-Ethnic Study of Atherosclerosis) who had complete parity data and underwent CMR. Parity was categorized as 0 live births, 1 to 2, 3 to 4, and ≥5 live births. Multivariable regression models were constructed to assess the associations of parity status, history of null gravidity, age at menopause and HRT with CMR obtained measures of IMF (extracellular volume [ECV], native-T1 time) and myocardial scar.
UNASSIGNED: Women with a history of nulliparity had greater ECV% (β = 0.95 ± 0.28, P = 0.001) and native-T1 ms (β = 10.6 ± 4.9, P = 0.03) than those who had 1 to 2 live births. These associations were independent of age, traditional cardiovascular risk factors, and interim cardiovascular events. Similar associations were found for women with a history of null gravidity compared to those with a history of pregnancy (ECV% [β = 0.7 ± 0.3, P = 0.02] and native-T1 ms [β = 10.6 ± 5.2, P = 0.04]). There was no association between age at menopause and HRT with markers of IMF. There were no associations between parity status, null gravidity, and age of menopause with the presence of myocardial scar; however, those who used HRT were independently associated with a lesser risk of myocardial scar (OR: 0.20; 95% CI: 0.05-0.82).
UNASSIGNED: In a multiethnic cohort, women with a history of nulliparity or null gravidity had greater IMF defined by CMR, while those who used HRT were less likely to have myocardial scar.
UNASSIGNED: This study examined the relationship between vital reproductive factors (parity, pregnancy, age at menopause, and use of hormone replacement therapy [HRT]) with interstitial myocardial fibrosis (IMF) and myocardial scar measured by cardiac magnetic resonance imaging (CMR) T1 mapping and late gadolinium enhancement, respectively.
UNASSIGNED: There were 596 female participants (mean age 67 ± 8 years) enrolled in MESA (Multi-Ethnic Study of Atherosclerosis) who had complete parity data and underwent CMR. Parity was categorized as 0 live births, 1 to 2, 3 to 4, and ≥5 live births. Multivariable regression models were constructed to assess the associations of parity status, history of null gravidity, age at menopause and HRT with CMR obtained measures of IMF (extracellular volume [ECV], native-T1 time) and myocardial scar.
UNASSIGNED: Women with a history of nulliparity had greater ECV% (β = 0.95 ± 0.28, P = 0.001) and native-T1 ms (β = 10.6 ± 4.9, P = 0.03) than those who had 1 to 2 live births. These associations were independent of age, traditional cardiovascular risk factors, and interim cardiovascular events. Similar associations were found for women with a history of null gravidity compared to those with a history of pregnancy (ECV% [β = 0.7 ± 0.3, P = 0.02] and native-T1 ms [β = 10.6 ± 5.2, P = 0.04]). There was no association between age at menopause and HRT with markers of IMF. There were no associations between parity status, null gravidity, and age of menopause with the presence of myocardial scar; however, those who used HRT were independently associated with a lesser risk of myocardial scar (OR: 0.20; 95% CI: 0.05-0.82).
UNASSIGNED: In a multiethnic cohort, women with a history of nulliparity or null gravidity had greater IMF defined by CMR, while those who used HRT were less likely to have myocardial scar.
摘要：
■最近的证据表明，生殖因素与女性射血分数保留的心力衰竭风险增加有关。然而,这种关系的致病途径尚不清楚.已发现亚临床心肌纤维化是很大一部分射血分数保留的心力衰竭患者的常见途径。
■这项研究检查了重要的生殖因素(胎次，怀孕,更年期的年龄，并使用激素替代疗法[HRT]）通过心脏磁共振成像（CMR）T1标测和晚期钆增强来测量间质性心肌纤维化（IMF）和心肌瘢痕，分别。
■有596名女性参与者（平均年龄67±8岁）参加了MESA（多种族动脉粥样硬化研究），他们有完整的胎次数据并接受了CMR。平价被归类为0个活产，1至2个、3至4个和≥5个活产。构建了多元回归模型来评估平价状态的关联，无妊娠史，绝经年龄和用CMR获得的IMF测量的HRT(细胞外体积[ECV]，天然T1时间）和心肌瘢痕。
■有无胎史的妇女的ECV％（β=0.95±0.28，P=0.001）和天然T1ms（β=10.6±4.9，P=0.03）高于有1至2个活产的妇女。这些关联与年龄无关，传统的心血管危险因素，和临时心血管事件。与有妊娠史的妇女相比，有无妊娠史的妇女发现了类似的关联（ECV％[β=0.7±0.3，P=0.02]和天然T1ms[β=10.6±5.2，P=0.04]）。绝经年龄和HRT与IMF标志物之间没有关联。平等状态之间没有关联，零妊娠,和绝经年龄与心肌瘢痕的存在;然而，使用HRT的患者与较低的心肌瘢痕风险独立相关(OR:0.20;95%CI:0.05~0.82).
■在一个多种族群体中，具有无效妊娠史或无效妊娠史的女性具有CMR定义的更大的IMF，而那些使用HRT的人不太可能出现心肌瘢痕。
■这项研究检查了重要的生殖因素(胎次，怀孕,更年期的年龄，并使用激素替代疗法[HRT]）通过心脏磁共振成像（CMR）T1标测和晚期钆增强来测量间质性心肌纤维化（IMF）和心肌瘢痕，分别。
■有596名女性参与者（平均年龄67±8岁）参加了MESA（多种族动脉粥样硬化研究），他们有完整的胎次数据并接受了CMR。平价被归类为0个活产，1至2个、3至4个和≥5个活产。构建了多元回归模型来评估平价状态的关联，无妊娠史，绝经年龄和用CMR获得的IMF测量的HRT(细胞外体积[ECV]，天然T1时间）和心肌瘢痕。
■有无胎史的妇女的ECV％（β=0.95±0.28，P=0.001）和天然T1ms（β=10.6±4.9，P=0.03）高于有1至2个活产的妇女。这些关联与年龄无关，传统的心血管危险因素，和临时心血管事件。与有妊娠史的妇女相比，有无妊娠史的妇女发现了类似的关联（ECV％[β=0.7±0.3，P=0.02]和天然T1ms[β=10.6±5.2，P=0.04]）。绝经年龄和HRT与IMF标志物之间没有关联。平等状态之间没有关联，零妊娠,和绝经年龄与心肌瘢痕的存在;然而，使用HRT的患者与较低的心肌瘢痕风险独立相关(OR:0.20;95%CI:0.05~0.82).
■在一个多种族群体中，具有无效妊娠史或无效妊娠史的女性具有CMR定义的更大的IMF，而那些使用HRT的人不太可能出现心肌瘢痕。
