Lower DHEA-S levels predict disease and worse outcomes in post-menopausal women with idiopathic, connective tissue disease- and congenital heart disease-associated pulmonary arterial hypertension. Issue 6 (28th June 2018)

• Record Type: Journal Article
• Authors: Baird, Grayson L.; Archer-Chicko, Christine; Barr, R. Graham; Bluemke, David A.; Foderaro, Andrew E.; Fritz, Jason S.; Hill, Nicholas S.; Kawut, Steven M.; Klinger, James R.; Lima, Joao A.C.; Mullin, Christopher J.; Ouyang, Pamela; Palevsky, Harold I.; Palmisicano, Amy J.; Pinder, Diane; Preston, Ioana R.; Roberts, Kari E.; Smith, K. Akaya; Walsh, Thomas; Whittenhall, Mary; Ventetuolo, Corey E.
• Is Part Of: European respiratory journal. Volume 51:Issue 6(2018)
• Publication Date: 2018-06-28
• Subjects: Respiratory organs -- Diseases -- Periodicals; Respiration -- Periodicals; 616.2
• DOI: 10.1183/13993003.00467-2018
• Languages: English
• ISSNs: 0903-1936

Abstract

High oestradiol (E2) and low dehydroepiandrosterone-sulfate (DHEA-S) levels are risk factors for pulmonary arterial hypertension (PAH) in men, but whether sex hormones are related to PAH in women is unknown. Post-menopausal women aged ≥55 years with PAH were matched by age and body mass index to women without cardiovascular disease. Plasma sex hormone levels were measured by immunoassay. Lower levels of DHEA-S (p<0.001) and higher levels of E2 (p=0.02) were associated with PAH. In PAH cases (n=112), lower DHEA-S levels were associated with worse haemodynamics (all p<0.01) and more right ventricular dilatation and dysfunction (both p=0.001). Lower DHEA-S levels were associated with shorter 6-min walking distance (6MWD) (p=0.01) and worse functional class (p=0.004). Each Ln(1 µg·dL −1 ) decrease in DHEA-S was associated with a doubling in the risk of death (hazard ratio 2.0, 95% CI 1.5–2.7; p<0.001). Higher levels of E2 were associated with shorter 6MWD (p=0.03) and worse functional class (p=0.01). High E2 and low DHEA-S levels are associated with the risk and severity of PAH in post-menopausal women. Hormonal modulation should be studied as a treatment strategy in PAH. Lower levels of DHEA-S predict risk of disease, clinical severity and death in post-menopausal women with PAH http://ow.ly/jo6e30jOFni