THE EFFECT OF ESTROGEN AND PROGESTOGEN REPLACEMENT THERAPY ON SYSTOLIC FLOW VELOCITY IN HEALTHY POSTMENOPAUSAL WOMEN

The effects on left ventricular systolic outflow velocity of 3 months' treatment with either continuous transdermal oestradiol or cyclical t ransdermal oestradiol with medroxyprogesterone acetate were assessed i n 34 healthy postmenopausal women. Cardiac flow was measured by pulsed wave Doppler echocardiography in 14 of these women and by continuous wave Doppler echocardiography in 20. Control studies were made in ten premenopausal women using pulse wave Doppler and in ten with continuou s wave Doppler. The indicators assessed were: ejection fraction (EF), preejection time (PEP), ejection time (ET), peak systolic flow velocit y over the aortic valve (PFV), acceleration time (AT), flow velocity i ntegral (FVI) and mean acceleration (MA). Postmenopausal women had sig nificantly lower EF, PFV, FVI, MA but longer AT and ET compared to pre menopausal women. After 3 months' transdermal oestradiol significant i ncreases in EF, PFV, FVI and MA were observed whilst AT decreased. The response in all cardiac flow indicators was similar with added proges togen. Blood pressure, however, increased after the addition of proges togen. Nevertheless the addition of progestogen does not attenuate the effect of oestrogen therapy on left ventricular systolic flow velocit y.