title: Role of estrogen in diastolic dysfunction.
abstract: The prevalence of left ventricular diastolic dysfunction (LVDD) sharply increases in women after menopause and may lead to heart failure. While evidence suggests that estrogens protect the premenopausal heart from hypertension and ventricular remodeling, the specific mechanisms involved remain elusive. Moreover, whether there is a protective role of estrogens against cardiovascular disease, and specifically LVDD, continues to be controversial. Clinical and basic science have implicated activation of the renin-angiotensin-aldosterone system (RAAS), linked to the loss of ovarian estrogens, in the pathogenesis of postmenopausal diastolic dysfunction. As a consequence of increased tissue ANG II and low estrogen, a maladaptive nitric oxide synthase (NOS) system produces ROS that contribute to female sex-specific hypertensive heart disease. Recent insights from rodent models that mimic the cardiac phenotype of an estrogen-insufficient or -deficient woman (e.g., premature ovarian failure or postmenopausal), including the ovariectomized congenic mRen2.Lewis female rat, provide evidence showing that estrogen modulates the tissue RAAS and NOS system and related intracellular signaling pathways, in part via the membrane G protein-coupled receptor 30 (GPR30; also called G protein-coupled estrogen receptor 1). Complementing the cardiovascular research in this field, the echocardiographic correlates of LVDD as well as inherent limitations to its use in preclinical rodent studies will be briefly presented. Understanding the roles of estrogen and GPR30, their interactions with the local RAAS and NOS system, and the relationship of each of these to LVDD is necessary to identify new therapeutic targets and alternative treatments for diastolic heart failure that achieve the cardiovascular benefits of estrogen replacement without its side effects and contraindications.
authors.affiliation: Department of Cardiology, Jinan Central Hospital, Affiliated with Shandong University, Jinan, China;
authors.forename: Zhuo
authors.initials: Z
authors.lastname: Zhao
authors.forename: Hao
authors.initials: H
authors.lastname: Wang
authors.forename: Jewell A
authors.initials: JA
authors.lastname: Jessup
authors.forename: Sarah H
authors.initials: SH
authors.lastname: Lindsey
authors.forename: Mark C
authors.initials: MC
authors.lastname: Chappell
authors.forename: Leanne
authors.initials: L
authors.lastname: Groban
mesh_terms: D000367:Age Factors; D000818:Animals; D003971:Diastole / Q000187:drug effects; D004195:Disease Models, Animal; D015914:Estrogen Replacement Therapy; D004967:Estrogens / Q000172:deficiency / Q000378:metabolism* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D009206:Myocardium / Q000378:metabolism*; D019001:Nitric Oxide Synthase / Q000378:metabolism; D017698:Postmenopause / Q000378:metabolism; D017382:Reactive Oxygen Species / Q000378:metabolism; D011960:Receptors, Estrogen / Q000378:metabolism; D043562:Receptors, G-Protein-Coupled / Q000378:metabolism; D012084:Renin-Angiotensin System; D012307:Risk Factors; D012737:Sex Factors; D015398:Signal Transduction; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology / Q000378:metabolism* / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000187:drug effects
chemical_list: D004967:Estrogens; C109584:GPER1 protein, human; D017382:Reactive Oxygen Species; D011960:Receptors, Estrogen; D043562:Receptors, G-Protein-Coupled; D019001:Nitric Oxide Synthase
keywords: Doppler echocardiography; G protein-coupled receptor 30; diastolic dysfunction; estrogen; mRen2; sex differences