Scatà Costanza, Ferreira Felipe C, Padilha Michelle C S V, Carandina Angelica, Asnaghi Riccardo, Bellocchi Chiara, Tobaldini Eleonora, Montano Nicola, Soares Pedro Paulo da S, Rodrigues Gabriel D
Department of Internal Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Department of Physiology and Pharmacology, Fluminense Federal University, Niterói, Brazil.
Front Cardiovasc Med. 2024 Aug 20;11:1402086. doi: 10.3389/fcvm.2024.1402086. eCollection 2024.
Although both aging and menopause influence cardiovascular autonomic control, the effect of menopause remains unclear. The current study was undertaken to test the hypothesis that post-menopausal women (PMW) have a blunted cardiovascular autonomic adjustment to active standing compared to pre-menopausal women. Thus, we compared the heart rate variability (HRV) indexes from supine (SUP) to orthostatic (ORT) positions among young women (YW), young men (YM), older men (OM), and PMW.
The participants rested for 10 min in SUP and then stood up and remained for 5 min in ORT. ECG was continuously recorded, and R-R time series of about 300 beats were analyzed using linear (spectral analysis) and non-linear (symbolic analysis) methods. The variation from SUP to ORT was calculated ( = ORT-SUP) for each HRV index.
In SUP, no difference was found for any HRV index among groups. However, 0V% and LFn (cardiac sympathetic modulation) were reduced in PWM compared to all groups (OM, YW, and YM), while 2UV% and HFn (cardiac vagal modulation) were reduced in PMW than the younger group (YW and YM). No differences were found among the male groups (OM and YM).
In light of our results, the cardiac autonomic dynamic response to orthostatic stress is blunted in post-menopausal women compared to younger women and older men, a finding that might be influenced not only by aging.
尽管衰老和绝经都会影响心血管自主神经控制，但绝经的影响仍不明确。本研究旨在检验以下假设：与绝经前女性相比，绝经后女性（PMW）对主动站立时的心血管自主神经调节减弱。因此，我们比较了年轻女性（YW）、年轻男性（YM）、老年男性（OM）和PMW从仰卧位（SUP）到直立位（ORT）时的心率变异性（HRV）指标。
参与者在仰卧位休息10分钟，然后站立并在直立位保持5分钟。持续记录心电图，并使用线性（频谱分析）和非线性（符号分析）方法分析约300次心跳的R-R时间序列。计算每个HRV指标从仰卧位到直立位的变化（=ORT-SUP）。
在仰卧位时，各组之间的任何HRV指标均未发现差异。然而，与所有组（OM、YW和YM）相比，PMW的0V%和LFn（心脏交感神经调制）降低，而与年轻组（YW和YM）相比，PMW的2UV%和HFn（心脏迷走神经调制）降低。男性组（OM和YM）之间未发现差异。
根据我们的结果，与年轻女性和老年男性相比，绝经后女性对直立位应激的心脏自主神经动态反应减弱，这一发现可能不仅受衰老影响。
