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38 ENDOTHELIAL DYSFUNCTION IN YOUNG WOMEN WITH PREMATURE OVARIAN FAILURE AND SURGICAL MENOPAUSE
9th European Congress on Menopause and Andropause / Maturitas 71, Supplement 1 (2012) S1–S82
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ENDOTHELIAL DYSFUNCTION IN YOUNG WOMEN WITH PREMATURE OVARIAN FAILURE AND SURGICAL MENOPAUSE
LOW LEVEL OF PHYSICAL FITNESS IS A PREDICTOR OF POOR PROGNOSIS IN MEN WITH STABLE HEART FAILURE
N. Sharashkina, O. Tkacheva, N. Runikhina, L. Butoreva, I. Novikova. Department of Physician, V. I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Moscow, Russia
K. Wegrzynowska-Teodorczyk 1,2 , E. Rudzinska 1,2 , K. Nowakowska 2 , M. Lazorczyk 2 , A. Lejczak 1,2 , E. Jankowska 2 , W. Banasiak 2 , P. Ponikowski 2 , M. Wozniewski 1 . 1 University of Physical Education; 2 Cardiology Department, 4th Military Hospital, Wroclaw, Poland
Introduction: Recent studies indicated increasing cardiovascular morbidity in young women. This may be due to an increase in traditional and non-traditional risk factors among women of reproductive age. We studied premature ovarian failure (POF) and surgical menopause (SM) in young women and assessed the impact of these factors on endothelial function, atherosclerotic changes and lipid metabolism. Methods: We analyzed serum levels of total cholesterol (TC), HDL-C, LDL-C and triglycerides (TG). Endothelium-dependent vasodilation and carotid artery intima-media thickness (CA-IMT) were evaluated in 16 patients with POF, 14 with SM and 17 healthy controls (CN). Inter-group differences were calculated using Student’s t-test. Results: We found a worse lipid profile among women with POF and SM. LDL-C was increased significantly in POF and SM (POF: 3.36 mmol/l [SD 0.51] and SM: 3.15 mmol/l [SD 0.46] vs CN: 2.82 mmol/l [SD 0.36], p<0.05); TC and TG were higher in the POF and SM groups, but not significantly (p>0.05). Compared to controls, endothelium-dependent vasodilation was significantly reduced in POF and SM patients (10.5% [SD 4.3] and 8.8% [SD 3.1] vs 14.5% [SD 3.6], p<0.05). The mean combined CA-IMT was significantly higher in POF and SM patients (0.76mm [SD 0.08] and 0.73mm [SD 0.09], respectively vs 0.52mm [SD 0.04], p<0.05). Conclusions: We conclude that impaired endothelial vasoreactivity and increased CA-IMT are prevalent in POF and SM patients and are associated with traditional risk factors that strongly suggest that POF and SM could be a risk factor for atherosclerosis.
39 DOES THE USE OF CONTRACEPTIVES AFFECT THE LIPID LEVELS AND AUTONOMIC MODULATION OF HEART RATE IN PREMENOPAUSAL WOMEN?
Heart Failure (HF) occurs mainly in elderly men. HF is a clinical and social problem due to old age, poor quality of life and fatal prognosis. The aim of the study was assessment of the relationship between physical fitness level and prognosis of patients with HF. Methods: The research covered 209 men with systolic HF (age 68±11 years, NYHA class [I/II/III/IV] 34/95/81/9, EF% 29±6%). Physical fitness was evaluated by Fullerton Test, which asses: agility-stand up and go [SU], lower body strength-chair stand [CHS], upper body strength-arm curl [AC], lower body flexibility-chair sit and reach [SR], upper body flexibility-back scratch [BS], aerobic endurance-6minute walk test [6MWT]. The maximal torque of quadriceps muscle (Mmax ) was evaluated by dynamometer’s Summer. Patients were followed up for at least 1 year, and the primary end-point was cardiovascular mortality. Results: Average results of tests: SU: 6,1±1,8 (s); CHS: 13,0±4,1 (number); AC: 13,6±4,4 (number); 6MWT: 447±126 (m); SR: −1,3±10,4 (cm); BS: −9,9±12,4 (cm); Mmax : 86,5±28 (Nm). During follow-up (384±112 days) 29% patients died. In multivariable Cox proportional hazard analysis significant predictors of increased 12-month cardiovascular mortality was: distance of 6MWT (↓10 m) HR=1,04 (95%CI: 1,01-1,08), strength: CHS (↓1 repetition) HR=1,06 (95%CI: 1,0- 1,15); AC (↓1 repetition) HR=1,09 (95%CI: 1,01-1,16), Mmax (↓10 Nm) HR=1,11 (95%CI: 1,01-1,23), agility SU (↑1 sec) HR=1,35 (95%CI: 1,2-1,60), serum UA (↑10mg%) HR=1,20 (95%CI: 1,05-1,40), plasma NT-pro BNP, (↑500 pg/ml HR=1,02 (95%CI: 1,0-1,04) EF%, (↓1%) HR=1,04 (95%CI: 1,02-1,08) and advanced HF (NYHA I-II vs. III-IV) HR=1,5 (95%CI: 1,0-2,3). The flexibility had not a significant impact on the prediction of death. Conclusion: The lower level of physical fitness predicts poor outcome in men with stable HF.
N.Y. Tamburús 1 , A.C.S. Rebelo 2 , C.P. Andrade 1 , A.M. Catai 2 , A.C.M. Takahashi 2 , E. da Silva 1 . 1 Faculty of Health Sciences, Methodist University of Piracicaba, Piracicaba; 2 Physiotherapy Department, Federal University of São Carlos, São Carlos, Brazil
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Objective: Evaluate and compare the lipid dosages and autonomic modulation of heart rate (HR) in users and non-users of female oral contraceptives (OCs). Methodology: 37 sedentary women (20 non-users of OCs (control group CG) and 17 users of OCs (treatment group - TG), whose HR was measured at rest in the supine position (7th to 10th day of the menstrual cycle (CG) and on the 21st (active phase) and 28th day of medication (inactive phase) (TG)), whose blood was subjected to biochemical analysis. The R-R intervals were measured with a heart monitor (Instramed Miniscope II) and processed with a Lab-PC+ analog-to-digital converter (National Instruments) equipped with a computer interface. HR variability (HRV) was analyzed based on Shannon’s entropy (SE) and symbolic analysis (0V% and 2ULV% patterns). Statistical analysis: Mann Whitney test (p<0.05). Results: The CG presented a higher complexity of the series (SE = 3.89), expressed in median values, than the TG (active phase) (SE = 3.55). As for sympathetic (0V%) and parasympathetic (2VD%), modulation, no statistical difference was found between the groups. However, the TG presented higher sympathetic modulation in the active phase than in the inactive phase (0V% = 12.04; 5.53, respectively). The levels of total cholesterol (mg.dL), LDL (mg/dL) and triglycerides (mg/dL) were higher in the TG (198; 127.2; 108, respectively) than in the CG (137; 80;57, respectively). Conclusion: OCs contribute to modify the lipid metabolism and lower the HRV, which is favorable as an important risk factor for the development of coronary artery disease.
D. Kalka 1,2 , Z. Domagala 3 , J. Wojcieszczyk 4 , L. Rusiecki 1 , P. Koleda 1 , A. Janocha 5 , W. Marciniak 6 , A. Popielewicz-Kautz 6 , M. Rusiecka 7 , W. Pilecki 1 . 1 Pathophysiology, Wroclaw Medical University; 2 Cardiac Rehabilitation and Prevention, “Creator” Centre; 3 Normal Anatomy, Wrocław Medical University; 4 Physiotherapy in Preventive and Surgical Medicine, University School of Physical Education; 5 Physiology, Wroclaw Medical University, Wroclaw; 6 Cardiology, Magodent Medical Centre, Warszawa; 7 Oncology and Gynaecological Oncology Clinic, Wroclaw Medical University, Wroclaw, Poland
SIX MONTH CYCLE OF CARDIAC REHABILITATION IN PHYSICAL EFFICIENCY ALTERATION OF WOMEN TREATED INVASIVELY DUE TO ISCHEMIC HEART DISEASE
Despite ample evidence supporting the beneficial effect of cardiac rehabilitation (CR) on the human body, women participate in CR cycles much less often than men. The aim of the work is an assessment of the influence of a 6-month CR cycle at outpatient clinics on physical efficiency (PE) of women treated invasively due to ischemic heart disease (IHD). Altogether, 167 patients treated invasively for IHD were analysed. The study population consisted of 85 women (average age 64.8 years old) and the control group of 82 man (average age 64.6 years old). All patients were subjected to the treadmill test twice (at the beginning and the end of the CR cycle). The patients’ PE was analysed by determination of the duration of the exertion phase in the initial treadmill test (T1 ) and the final test (T2 ) as well as the time increment of the test (t). T1 in the female group was statistically significantly shorter than in the male group (626.59±166.76 versus 719.93±121.71; p=0.0003). T2 in the female group was also statistically significantly shorter than in the male group (756.33±168.71 vs 851.48±134.20, p=0.0002). t in the female and male groups did not differ significantly. In both groups, the value of T1 did not determine statistically significantly the value T. Conclusions: 1. PE of women, both at the beginning and the end of the CR cycle, was significantly lower than that of men. 2. The CR cycle in both groups triggered a similar insignificantly different increase of PE.
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ENDOTHELIAL DYSFUNCTION IN YOUNG WOMEN WITH PREMATURE OVARIAN FAILURE AND SURGICAL MENOPAUSE
LOW LEVEL OF PHYSICAL FITNESS IS A PREDICTOR OF POOR PROGNOSIS IN MEN WITH STABLE HEART FAILURE
N. Sharashkina, O. Tkacheva, N. Runikhina, L. Butoreva, I. Novikova. Department of Physician, V. I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Moscow, Russia
K. Wegrzynowska-Teodorczyk 1,2 , E. Rudzinska 1,2 , K. Nowakowska 2 , M. Lazorczyk 2 , A. Lejczak 1,2 , E. Jankowska 2 , W. Banasiak 2 , P. Ponikowski 2 , M. Wozniewski 1 . 1 University of Physical Education; 2 Cardiology Department, 4th Military Hospital, Wroclaw, Poland
Introduction: Recent studies indicated increasing cardiovascular morbidity in young women. This may be due to an increase in traditional and non-traditional risk factors among women of reproductive age. We studied premature ovarian failure (POF) and surgical menopause (SM) in young women and assessed the impact of these factors on endothelial function, atherosclerotic changes and lipid metabolism. Methods: We analyzed serum levels of total cholesterol (TC), HDL-C, LDL-C and triglycerides (TG). Endothelium-dependent vasodilation and carotid artery intima-media thickness (CA-IMT) were evaluated in 16 patients with POF, 14 with SM and 17 healthy controls (CN). Inter-group differences were calculated using Student’s t-test. Results: We found a worse lipid profile among women with POF and SM. LDL-C was increased significantly in POF and SM (POF: 3.36 mmol/l [SD 0.51] and SM: 3.15 mmol/l [SD 0.46] vs CN: 2.82 mmol/l [SD 0.36], p<0.05); TC and TG were higher in the POF and SM groups, but not significantly (p>0.05). Compared to controls, endothelium-dependent vasodilation was significantly reduced in POF and SM patients (10.5% [SD 4.3] and 8.8% [SD 3.1] vs 14.5% [SD 3.6], p<0.05). The mean combined CA-IMT was significantly higher in POF and SM patients (0.76mm [SD 0.08] and 0.73mm [SD 0.09], respectively vs 0.52mm [SD 0.04], p<0.05). Conclusions: We conclude that impaired endothelial vasoreactivity and increased CA-IMT are prevalent in POF and SM patients and are associated with traditional risk factors that strongly suggest that POF and SM could be a risk factor for atherosclerosis.
39 DOES THE USE OF CONTRACEPTIVES AFFECT THE LIPID LEVELS AND AUTONOMIC MODULATION OF HEART RATE IN PREMENOPAUSAL WOMEN?
Heart Failure (HF) occurs mainly in elderly men. HF is a clinical and social problem due to old age, poor quality of life and fatal prognosis. The aim of the study was assessment of the relationship between physical fitness level and prognosis of patients with HF. Methods: The research covered 209 men with systolic HF (age 68±11 years, NYHA class [I/II/III/IV] 34/95/81/9, EF% 29±6%). Physical fitness was evaluated by Fullerton Test, which asses: agility-stand up and go [SU], lower body strength-chair stand [CHS], upper body strength-arm curl [AC], lower body flexibility-chair sit and reach [SR], upper body flexibility-back scratch [BS], aerobic endurance-6minute walk test [6MWT]. The maximal torque of quadriceps muscle (Mmax ) was evaluated by dynamometer’s Summer. Patients were followed up for at least 1 year, and the primary end-point was cardiovascular mortality. Results: Average results of tests: SU: 6,1±1,8 (s); CHS: 13,0±4,1 (number); AC: 13,6±4,4 (number); 6MWT: 447±126 (m); SR: −1,3±10,4 (cm); BS: −9,9±12,4 (cm); Mmax : 86,5±28 (Nm). During follow-up (384±112 days) 29% patients died. In multivariable Cox proportional hazard analysis significant predictors of increased 12-month cardiovascular mortality was: distance of 6MWT (↓10 m) HR=1,04 (95%CI: 1,01-1,08), strength: CHS (↓1 repetition) HR=1,06 (95%CI: 1,0- 1,15); AC (↓1 repetition) HR=1,09 (95%CI: 1,01-1,16), Mmax (↓10 Nm) HR=1,11 (95%CI: 1,01-1,23), agility SU (↑1 sec) HR=1,35 (95%CI: 1,2-1,60), serum UA (↑10mg%) HR=1,20 (95%CI: 1,05-1,40), plasma NT-pro BNP, (↑500 pg/ml HR=1,02 (95%CI: 1,0-1,04) EF%, (↓1%) HR=1,04 (95%CI: 1,02-1,08) and advanced HF (NYHA I-II vs. III-IV) HR=1,5 (95%CI: 1,0-2,3). The flexibility had not a significant impact on the prediction of death. Conclusion: The lower level of physical fitness predicts poor outcome in men with stable HF.
N.Y. Tamburús 1 , A.C.S. Rebelo 2 , C.P. Andrade 1 , A.M. Catai 2 , A.C.M. Takahashi 2 , E. da Silva 1 . 1 Faculty of Health Sciences, Methodist University of Piracicaba, Piracicaba; 2 Physiotherapy Department, Federal University of São Carlos, São Carlos, Brazil
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Objective: Evaluate and compare the lipid dosages and autonomic modulation of heart rate (HR) in users and non-users of female oral contraceptives (OCs). Methodology: 37 sedentary women (20 non-users of OCs (control group CG) and 17 users of OCs (treatment group - TG), whose HR was measured at rest in the supine position (7th to 10th day of the menstrual cycle (CG) and on the 21st (active phase) and 28th day of medication (inactive phase) (TG)), whose blood was subjected to biochemical analysis. The R-R intervals were measured with a heart monitor (Instramed Miniscope II) and processed with a Lab-PC+ analog-to-digital converter (National Instruments) equipped with a computer interface. HR variability (HRV) was analyzed based on Shannon’s entropy (SE) and symbolic analysis (0V% and 2ULV% patterns). Statistical analysis: Mann Whitney test (p<0.05). Results: The CG presented a higher complexity of the series (SE = 3.89), expressed in median values, than the TG (active phase) (SE = 3.55). As for sympathetic (0V%) and parasympathetic (2VD%), modulation, no statistical difference was found between the groups. However, the TG presented higher sympathetic modulation in the active phase than in the inactive phase (0V% = 12.04; 5.53, respectively). The levels of total cholesterol (mg.dL), LDL (mg/dL) and triglycerides (mg/dL) were higher in the TG (198; 127.2; 108, respectively) than in the CG (137; 80;57, respectively). Conclusion: OCs contribute to modify the lipid metabolism and lower the HRV, which is favorable as an important risk factor for the development of coronary artery disease.
D. Kalka 1,2 , Z. Domagala 3 , J. Wojcieszczyk 4 , L. Rusiecki 1 , P. Koleda 1 , A. Janocha 5 , W. Marciniak 6 , A. Popielewicz-Kautz 6 , M. Rusiecka 7 , W. Pilecki 1 . 1 Pathophysiology, Wroclaw Medical University; 2 Cardiac Rehabilitation and Prevention, “Creator” Centre; 3 Normal Anatomy, Wrocław Medical University; 4 Physiotherapy in Preventive and Surgical Medicine, University School of Physical Education; 5 Physiology, Wroclaw Medical University, Wroclaw; 6 Cardiology, Magodent Medical Centre, Warszawa; 7 Oncology and Gynaecological Oncology Clinic, Wroclaw Medical University, Wroclaw, Poland
SIX MONTH CYCLE OF CARDIAC REHABILITATION IN PHYSICAL EFFICIENCY ALTERATION OF WOMEN TREATED INVASIVELY DUE TO ISCHEMIC HEART DISEASE
Despite ample evidence supporting the beneficial effect of cardiac rehabilitation (CR) on the human body, women participate in CR cycles much less often than men. The aim of the work is an assessment of the influence of a 6-month CR cycle at outpatient clinics on physical efficiency (PE) of women treated invasively due to ischemic heart disease (IHD). Altogether, 167 patients treated invasively for IHD were analysed. The study population consisted of 85 women (average age 64.8 years old) and the control group of 82 man (average age 64.6 years old). All patients were subjected to the treadmill test twice (at the beginning and the end of the CR cycle). The patients’ PE was analysed by determination of the duration of the exertion phase in the initial treadmill test (T1 ) and the final test (T2 ) as well as the time increment of the test (t). T1 in the female group was statistically significantly shorter than in the male group (626.59±166.76 versus 719.93±121.71; p=0.0003). T2 in the female group was also statistically significantly shorter than in the male group (756.33±168.71 vs 851.48±134.20, p=0.0002). t in the female and male groups did not differ significantly. In both groups, the value of T1 did not determine statistically significantly the value T. Conclusions: 1. PE of women, both at the beginning and the end of the CR cycle, was significantly lower than that of men. 2. The CR cycle in both groups triggered a similar insignificantly different increase of PE.