Female mice with menopause exhibit coronary microvascular disease

Menopause is a natural process as women age, and women with menopause are at higher risk of having cardiovascular diseases than men at the same age. Coronary microvascular disease (CMD) is one of the causes of angina, and the prevalence of CMD is higher in women than in men, and more postmenopausal women have CMD than premenopausal women. However, the causes of CMD in postmenopausal women are not clear. In this study, we investigate whether and how menopause leads to coronary microvascular disease in female mice. Menopausal mice were generated by administering a 20-day injection of 4-Vinylcyclohexene diepoxide (VCD, 160 mg/kg/day in sesame oil, i.p.). VCD gradually destroys primordial and primary follicles in ovaries and leads to ovary failure while keeping the ovary tissues intact; this model is close to the natural progression of human menopause. The vehicle, sesame oil, was administered in control mice. Coronary flow velocity reserve (CFVR) was measured to assess coronary microvascular function. Isometric tension was conducted in third-order coronary arteries (CAs). Capillary density was measured and compared in the left ventricle. Experiments were performed at 6 weeks (perimenopause period) and 8 weeks (post-menopause period) after the injection of VCD or vehicle in female mice. There was no significant difference in CFVR between VCD-injected mice and vehicle-injected mice 6 weeks after the injection. However, at 8 weeks after the injection, VCD-injected mice exhibited a significant decline in CFVR compared to the control mice. Coronary microvascular dysfunction can be driven by attenuated vascular relaxation in small coronary arteries and/or capillary rarefaction. We first conducted isometric tension and found that endothelium-dependent relaxation was significantly attenuated in VCD-injected mice at 8 weeks after the injection, but not at 6 weeks, compared to the controls. There was no significant difference in EC-independent relaxation between the two groups at any age. Interestingly, there was no significant difference in capillary density between VCD-injected mice and vehicle-injected mice at 6 weeks and 8 weeks after the injection. Postmenopausal mice, but not perimenopausal mice, develop CMD due to attenuated endothelium-dependent relaxation. This suggests that improving endothelium-dependent relaxation is the potential mechanism to treat CMD in postmenopausal women. Supported by NIH R01HL142214 and DOD W81XWH2110472. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.