Effects of a single dose of oral estrogen on left ventricular diastolic function in hypertensive postmenopausal women with diastolic dysfunction

Objective: To evaluate the acute effects of a single dose of oral estrogen on left ventricular diastolic function in hypertensive postmenopausal women with diastolic dysfunction. Design: Prospective, double-blind, placebo-controlled, clinical study. Setting: Cardiology and postmenopausal outpatient clinics of a university h ospital. Patient(s): Thirty postmenopausal women with hypertension (diastolic blood pressure of >90 mm Hg) and left ventricular diastolic dysfunction (mitral E /A ratio [the ratio of peak velocity of early mitral diastolic filling to l ate diastolic filling] of <1 and isovolumic relaxation time of >100 ms) wer e included in the study. Thirty normotensive postmenopausal women with norm al left ventricular diastolic function served as the control group. Intervention(s): Conjugated equine estrogen (0.625 mg) was given orally. Le ft ventricular diastolic function was assessed by Doppler echocardiography at baseline and 3 hours after the administration of estrogen. Main Outcome Measure(s): Left ventricular diastolic filling as assessed by Doppler echocardiography. Result(s): Estrogen had no effect on heart rate or blood pressure in either study group. The baseline E/A ratios were 0.72 +/- 0.26 and 1.22 +/- 0.30, and the isovolumic relaxation times were 122 +/- 18 ms and 89 +/- ms in th e hypertensive and normotensive groups, respectively. Estrogen had no signi ficant effect on any of the Doppler parameters in the normotensive group. I n the hypertensive group, there was a trend toward normalization of the E/A ratio (from 0.73 +/- 0.11 to 0.84 +/- 20) and a significant improvement in the isovolumic relaxation time (from 124 +/- 20 ms to 105 +/- 13 ms) in re sponse to the administration of estrogen compared with placebo. Conclusion(s): A single dose of oral estrogen caused a significant improvem ent in left ventricular diastolic filling in hypertensive postmenopausal wo men with diastolic dysfunction. (Fertil Steril(R) 2000;73:66-71. (C) 1999 b y American Society for Reproductive Medicine.)