THE EFFECT OF THE HYPOESTROGENIC STATE, INDUCED BY GONADOTROPIN-RELEASING-HORMONE AGONIST, ON DOPPLER-DERIVED PARAMETERS OF AORTIC FLOW

The effect of the hypoestrogenic state, induced by a GnRH agonist (GnR H-a), on cardiac function in healthy young women, was evaluated by Dop pler echocardiography performed before treatment and when. serum 17bet a-estradiol levels were suppressed by GnRH-a to 36.7 pmol/L. The follo wing parameters of aortic flow were measured: peak flow velocity, ejec tion time, and acceleration time. Additional parameters calculated wer e flow velocity integral, cardiac index, and mean acceleration. The st udy group included 15 menstruating women, aged 25-42 yr (mean, 33 yr), with symptomatic fibroids, endometriosis, or scheduled for in vitro f ertilization, who were treated with a GnRH-a. There were significant d ecreases in peak flow velocity (99 +/- 11 vs. 86 +/- 11 cm/s; P = 0.00 04) and cardiac index (3.0 +/- 0.7 vs. 2.5 +/- 0.5 L/min . m2; P = 0.0 02). A decrease that did not reach statistical significance was noted in flow velocity integral (18.9 +/- 2.7 vs. 16.5 +/- 3.4 cm; P = 0.07) . Mean acceleration was decreased significantly (12.6 +/- 2.6 vs. 10.8 +/-1.8 m/s . s; P = 0.01), but no significant changes in acceleration time (81 +/- 16 vs. 83 +/- 10 ms; P = 0.7) or ejection time (296 +/- 25 vs. 295 +/-27 ms; P = 0.8) were observed. These results indicate th at estrogen deprivation is associated with smaller stroke volume and f low acceleration and might suggest that hypoestrogenism has a direct e ffect on cardiovascular performance.