PHYSIOLOGICAL ESTRADIOL REPLACEMENT THERAPY AND CARDIAC STRUCTURE ANDFUNCTION IN NORMAL POSTMENOPAUSAL WOMEN - A RANDOMIZED, DOUBLE-BLIND,PLACEBO-CONTROLLED, CROSSOVER TRIAL

Objective: To assess the effect of estradiol (E2) replacement therapy on cardiac structure and function in healthy post-menopausal women. Me thods: We conducted a randomized, double-blind, placebo-controlled, cr ossover study of 31 healthy postmenopausal female volunteer study subj ects (55-65 pears) using 12 weeks of micronized E2 replacement therapy (2 mg/day). Echocardiography and Doppler techniques were used to asse ss the cardiac effects of E2 at rest and during graded bicycle ergomet ry. Results: Crossover analysis demonstrated no carryover effects of e strogen treatment (which increased serum E2 15-fold to 37.6 pmol/L) on the cardiac characteristics measured. Estradiol treatment did not aff ect measurements of systolic function, diastolic function, left ventri cular mass, or pulmonary artery pressure at rest or during bicycle erg ometry. Left ventricular end-diastolic volume at rest was slightly hig her with E2 treatment (P = .03). However, this change was not reflecte d by changes in stroke volume, ejection fraction, or cardiac output. C onclusions: Estrogen replacement therapy, which results in physiologic serum concentrations, does not affect cardiac structure or function i n normal postmenopausal women after 12 weeks of treatment. Copyright ( C) 1997 by The American College of Obstetricians and Gynecologists.