Cardiac perfusion and function after high-intensity exercise training in late premenopausal and recent postmenopausal women: An MRI study

Background: We examined the influence of recent menopause and aerobic exercise training in women on myocardial perfusion, left ventricular (LV) dimension and function.

Methods: Two groups (n=14 each) of healthy late pre- (50.2±2.1 years) and recent postmenopausal (54.2±2.8 years) women underwent cardiac magnetic resonance imaging (cMRI) at baseline and after 12-weeks of high-intensity aerobic training. Measurements included LV morphology, systolic function and myocardial perfusion at rest and during an adenosine stress test,.

Results: At baseline, resting myocardial perfusion was lower in the post- than the premenopausal group (77±3 vs. 89±3 ml/100g/min; p=0.01), while adenosine induced myocardial perfusion was not different (p=0.81). After exercise training, resting myocardial perfusion was lower in both groups (66±2; p=0.002 vs 81±3 ml/100g/min; p=0.03). The adenosine induced change in myocardial perfusion was lower in the groups combined (by 402±17 ml/100g/min; p=0.02) and the adenosine induced increase ín heart rate was 10±2 bpm lower (p<0.0001) after training in both groups. Normalization of myocardial perfusion using an estimate of cardiac work, eliminated the differences in perfusion between the pre and postmenopausal groups and the effect of training. LV mass was higher in both groups (p=0.03; p=0.006) whereas LV end-diastolic (p=0.02) and stroke (p=0.045) volume were higher in the postmenopausal group after training.

Conclusions: Twelve weeks of exercise training increased LV mass and lowered resting and adenosine induced myocardial perfusion, an effect which was likely related to cardiac work. The current data also suggests that the early menopausal transition has limited impact on cardiac function and structure.