Effects of hormone replacement therapy on left ventricular diastolic function in postmenopausal women: a systematic review and meta-analysis

Postmenopausal women tend to experience significant changes in left ventricular diastolic function (LVDF). However, there are conflicting reports about LVDF between postmenopausal women on hormone replacement therapy (HRT) and those not on HRT. This meta-analysis is to evaluate the effects of HRT on LVDF in postmenopausal women. We conducted a systemic review of randomized controlled trials published up to December 31 2019 using Embase, Pubmed, and the Cochrane library database. Eight studies involving 668 postmenopausal women were identified. Our analysis indicated that the ratio of the peak velocity during early filing to late filling from atrial contraction improvement in HRT group was better than that in placebo group (MD 0.20, 95%CI 0.12 to 0.28). There was a significant reduction in deceleration time and left ventricular mass index in HRT group compared with placebo group (MD −21.01, 95%CI −40.11 to −1.91 vs MD −8.26, 95%CI −14.10 to −2.42). No significant difference was observed in left ventricular end systole diameter (MD 0.80, 95%CI −0.72 to 2.31), left ventricular end diastole diameter (MD −0.07, 95%CI −1.25 to 1.10), left atrial size (MD −0.33, 95%CI −1.34 to 0.68)and the isovolumic relaxation time (MD −12.08, 95%CI −27.65 to 3.5). Our meta-analysis illustrated that postmenopausal women seem to obtain more beneficial effects from HRT on LVDF, though future studies are required to elucidate the specific mechanisms for this phenomenon.