Heart failure & cardiomyopathies
Reproductive Factors Linked With Myocardial Fibrosis: MESA (Multi-Ethnic Study of Atherosclerosis)
Authors' conclusion
In a multiethnic cohort, women with a history of nulliparity or null gravidity had greater IMF defined by CMR, while those who used HRT were less likely to have myocardial scar.
Study context
- Population
- Women in MESA (mean age 67 ± 8 years) with complete parity data who underwent CMR
- Participants
- 596 female participants
- Exposure
- Reproductive factors vs CMR myocardial fibrosis and scar
- Outcome
- Interstitial myocardial fibrosis (ECV, native-T1 time by CMR T1 mapping) and myocardial scar (late gadolinium enhancement)
Methodological detailsmultiethnic cohort, multivariable regression
- Multiethnic cohort
- Multivariable regression
Main finding
As reported in the abstract
IMF by parity (nulliparity vs 1 to 2 live births)
β
0.95 ± 0.28 ECV%
P = 0.001
Interstitial myocardial fibrosis (IMF) by parity (nulliparity vs 1 to 2 live births)
β
10.6 ± 4.9 ms
P = 0.03
native-T1
Observational data: associations, not effects.
Further findings
Myocardial scar
| OR (95% CI) | ||
|---|---|---|
| HRTLesser risk of myocardial scar with HRT use | 0.20 (0.05–0.82) | |
| 0.050.21520Odds ratio (log scale) |
| Outcome | Estimate | P value |
|---|---|---|
| IMF, null gravidity vs pregnancyNull gravidity vs Pregnancy | β 0.7 ± 0.3 ECV% | P = 0.02 |
| IMF, null gravidity vs pregnancyNull gravidity vs Pregnancy · native-T1 | β 10.6 ± 5.2 ms | P = 0.04 |
IMF by age at menopause and HRT
- No association between age at menopause and HRT with markers of IMF
Myocardial scar
- No associations between parity status, null gravidity and age at menopause with myocardial scar
Original publication
Reproductive Factors Linked With Myocardial Fibrosis: MESA (Multi-Ethnic Study of Atherosclerosis). JACC Adv. Published 23 November 2023. doi:10.
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