Infertility and Subclinical Antecedents of Heart Failure With Preserved Ejection Fraction in the Framingham Heart Study

Infertility has been shown to be associated with a greater risk of incident heart failure with preserved ejection fraction (HFpEF). We studied the association of infertility with subclinical markers of HFpEF, including echocardiographic signs of cardiac remodeling and cardiac biomarkers.History of infertility was ascertained in 2002 women enrolled in the Framingham Heart Study. We examined the association of infertility with echocardiographic measures and cardiac biomarkers with multivariable-adjusted linear regression models. Among 2002 women (mean age 40.84 ± 9.71 years), 285 (14%) reported a history of infertility. Infertility was associated with a greater E/e' ratio (β=0.120, SE 0.057, p=0.04) even after adjustment for common confounders. Infertility was not associated with other echocardiographic measures or cardiac biomarkers.Infertility was associated with a greater E/e' ratio, a marker of diastolic dysfunction which may signal earlier subclinical cardiac remodeling in women with infertility.