TY - JOUR T1 - Lower DHEA-S levels predict disease and worse outcomes in post-menopausal women with idiopathic, connective tissue disease- and congenital heart disease-associated pulmonary arterial hypertension JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.00467-2018 VL - 51 IS - 6 SP - 1800467 AU - Grayson L. Baird AU - Christine Archer-Chicko AU - R. Graham Barr AU - David A. Bluemke AU - Andrew E. Foderaro AU - Jason S. Fritz AU - Nicholas S. Hill AU - Steven M. Kawut AU - James R. Klinger AU - Joao A.C. Lima AU - Christopher J. Mullin AU - Pamela Ouyang AU - Harold I. Palevsky AU - Amy J. Palmisicano AU - Diane Pinder AU - Ioana R. Preston AU - Kari E. Roberts AU - K. Akaya Smith AU - Thomas Walsh AU - Mary Whittenhall AU - Corey E. Ventetuolo Y1 - 2018/06/01 UR - http://erj.ersjournals.com/content/51/6/1800467.abstract N2 - High oestradiol (E2) and low dehydroepiandrosterone-sulfate (DHEA-S) levels are risk factors for pulmonary arterial hypertension (PAH) in men, but whether sex hormones are related to PAH in women is unknown.Post-menopausal women aged ≥55 years with PAH were matched by age and body mass index to women without cardiovascular disease. Plasma sex hormone levels were measured by immunoassay.Lower levels of DHEA-S (p<0.001) and higher levels of E2 (p=0.02) were associated with PAH. In PAH cases (n=112), lower DHEA-S levels were associated with worse haemodynamics (all p<0.01) and more right ventricular dilatation and dysfunction (both p=0.001). Lower DHEA-S levels were associated with shorter 6-min walking distance (6MWD) (p=0.01) and worse functional class (p=0.004). Each Ln(1 µg·dL−1) decrease in DHEA-S was associated with a doubling in the risk of death (hazard ratio 2.0, 95% CI 1.5–2.7; p<0.001). Higher levels of E2 were associated with shorter 6MWD (p=0.03) and worse functional class (p=0.01).High E2 and low DHEA-S levels are associated with the risk and severity of PAH in post-menopausal women. Hormonal modulation should be studied as a treatment strategy in PAH.Lower levels of DHEA-S predict risk of disease, clinical severity and death in post-menopausal women with PAH http://ow.ly/jo6e30jOFni ER -