Heart failure (HF) is a complex condition affecting >40 million people worldwide. It is defined by failure of the heart to pump (HF with reduced ejection fraction) or by the failure of the heart to relax, resulting in reduced filling but with preserved ejection fraction (HFpEF). HFpEF affects approximately 50% of patients with HF, most of whom are women. Given that the annual mortality ranges from 10% to 30% and as there are no treatments specifically directed for HFpEF, there is a need for better understanding of the underlying mechanisms of this condition. We put forward the hypothesis that the decline of estrogen at menopause might contribute to the pathogenesis of HFpEF and we highlight potential underlying mechanisms of estrogen action, which may attenuate the development of HFpEF. We also discuss areas in which additional research is needed to develop new approaches for prevention and treatment of HFpEF.

中文翻译：

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更年期相关的雌激素减少和 HFpEF 的发病机制

心力衰竭 (HF) 是一种复杂的疾病，影响全球超过 4000 万人。它的定义是心脏泵血衰竭（射血分数降低的 HF）或心脏无法舒张，导致充盈减少但射血分数保留 (HFpEF)。HFpEF 影响大约 50% 的 HF 患者，其中大多数是女性。鉴于年死亡率在 10% 到 30% 之间，并且由于没有专门针对 HFpEF 的治疗方法，因此需要更好地了解这种情况的潜在机制。我们提出了更年期雌激素下降可能有助于 HFpEF 发病机制的假设，并强调了雌激素作用的潜在潜在机制，这可能会减弱 HFpEF 的发展。