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  • 3 -7 (93) 2026 - Ubaydullaev Sh.A. - UTERINE ARTERY EMBOLIZATION FOR UTERINE FIBROIDS AND ADENOMYOSIS IN PERIMENOPAUSAL WOMEN: EFFECTS ON ENDOTHELIAL FUNCTION, SYSTEMIC INFLAMMATION, AND CARDIOVASCULAR RISK MARKERS — AN INTERIM ANALYSIS

3 -7 (93) 2026 - Ubaydullaev Sh.A. - UTERINE ARTERY EMBOLIZATION FOR UTERINE FIBROIDS AND ADENOMYOSIS IN PERIMENOPAUSAL WOMEN: EFFECTS ON ENDOTHELIAL FUNCTION, SYSTEMIC INFLAMMATION, AND CARDIOVASCULAR RISK MARKERS — AN INTERIM ANALYSIS

UTERINE ARTERY EMBOLIZATION FOR UTERINE FIBROIDS AND ADENOMYOSIS IN PERIMENOPAUSAL WOMEN: EFFECTS ON ENDOTHELIAL FUNCTION, SYSTEMIC INFLAMMATION, AND CARDIOVASCULAR RISK MARKERS — AN INTERIM ANALYSIS

Ubaydullaev Sh.A. - Republican Specialized Scientific and Practical Medical Center of Therapy and Medical Rehabilitation, Tashkent, Uzbekistan

Resume

Background. Uterine fibroids and adenomyosis are among the most prevalent benign gynecological conditions in perimenopausal women. While hysterectomy remains the definitive treatment, growing interest surrounds uterine artery embolization (UAE) as a uterus-sparing alternative. The systemic cardiovascular and endothelial effects of UAE in this population have not been fully characterized. Objective. To evaluate the effects of bilateral UAE on endothelial function biomarkers, systemic inflammation, oxidative stress, ovarian hormone levels, and cardiac function in perimenopausal women with uterine fibroids and/or adenomyosis. Methods. This prospective, single-arm, interim analysis includes 77 consecutive women (mean age 42.2 ± 7.8 years) who underwent bilateral UAE for symptomatic uterine fibroids and/or adenomyosis at a single tertiary center. Assessments were performed at baseline (T0), 2 months (T1), and 6 months (T2) post-procedure. Primary endpoints included changes in endothelin-1 (ET-1), nitric oxide (NO), high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), TNF-α, malondialdehyde (MDA), superoxide dismutase (SOD), estradiol, and echocardiographic parameters (GLS, E/e'). Fibroid volume reduction was assessed at 12 months (T3) in all patients. Results. UAE produced a progressive reduction in the largest fibroid volume from 38.2 ± 35.3 cm³ at baseline to 5.4 ± 5.0 cm³ at 12 months (85.8% reduction; p < 0.001). Hemoglobin increased significantly from 87.3 ± 20.2 to 124.7 ± 4.5 g/L at 2 months (p < 0.001). Significant improvements in endothelial function were observed: ET-1 decreased from 3.76 ± 0.79 to 2.42 ± 0.56 pg/mL (p < 0.001) and NO increased from 30.0 ± 5.8 to 45.8 ± 8.4 µmol/L (p < 0.001) at 6 months. All pro-inflammatory markers declined significantly. Estradiol levels remained stable (132.5 ± 43.3 vs. 130.4 ± 43.4 pg/mL; p = 0.75). Metabolic parameters, GLS, and E/e' improved significantly. Conclusions. Bilateral UAE not only achieves effective and durable reduction of fibroid burden but is associated with significant improvement in endothelial function, inflammatory, and oxidative stress markers without compromising ovarian reserve. These findings support UAE as a metabolically and cardiovascularly favorable option for perimenopausal women with uterine fibroids and/or adenomyosis.

Keywords: uterine artery embolization, uterine fibroids, adenomyosis, endothelial dysfunction, endothelin-1, nitric oxide, cardiovascular risk, perimenopause, oxidative stress, systemic inflammation

First page

20

Last page

29

For citation:Ubaydullaev Sh.A. - UTERINE ARTERY EMBOLIZATION FOR UTERINE FIBROIDS AND ADENOMYOSIS IN PERIMENOPAUSAL WOMEN: EFFECTS ON ENDOTHELIAL FUNCTION, SYSTEMIC INFLAMMATION, AND CARDIOVASCULAR RISK MARKERS — AN INTERIM ANALYSIS//New Day in Medicine 7(93)2026 20-29 https://newdayworldmedicine.com/en/new_day_medicine/7-93-2026

List of References

  1. Stewart EA. Uterine fibroids. Lancet. 2001;357(9252):293–298. doi:10.1016/S0140-6736(00)03622-9.
  2. Bulun SE. Uterine fibroids. N Engl J Med. 2013;369(14):1344–1355. doi:10.1056/NEJMra1209993.
  3. Vercellini P, Viganò P, Somigliana E, Fedele L. Adenomyosis: epidemiological factors, clinical presentation and treatment. Lancet. 2014;384(9954):1440–1447. doi:10.1016/S0140-6736(14)60126-8.
  4. Manson JE, Chlebowski RT, Stefanick ML, Aragaki AK, Rossouw JE, Prentice RL, et al. Menopausal hormone therapy and health outcomes during the intervention and extended poststopping phases of the Women's Health Initiative randomized trials. JAMA. 2013;310(13):1353–1368. doi:10.1001/jama.2013.278040.
  5. Rossouw JE, Anderson GL, Prentice RL, LaCroix AZ, Kooperberg C, Stefanick ML, et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women's Health Initiative randomized controlled trial. JAMA. 2002;288(3):321–333. doi:10.1001/jama.288.3.321.
  6. World Health Organization. Cardiovascular diseases (CVDs): Fact sheet. Geneva: WHO; 2021.
  7. Deanfield JE, Halcox JP, Rabelink TJ. Endothelial function and dysfunction: testing and clinical relevance. Circulation. 2007;115(10):1285–1295. doi:10.1161/CIRCULATIONAHA.106.652859.
  8. Bonetti PO, Lerman LO, Lerman A. Endothelial dysfunction: a marker of atherosclerotic risk. Arterioscler Thromb Vasc Biol. 2003;23(2):168–175. doi:10.1161/01.ATV.0000051384.43104.FC.
  9. Libby P. Inflammation in atherosclerosis. Nature. 2002;420(6917):868–874. doi:10.1038/nature01323.
  10. Laughlin-Tommaso SK, Khan Z, Weaver AL, Smith CY, Rocca WA, Stewart EA. Cardiovascular and metabolic morbidity after hysterectomy with ovarian conservation: a cohort study. Menopause. 2018;25(5):483–492. doi:10.1097/GME.0000000000001043.

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