Effects of 15 months of 17 beta-estradiol and dydrogesterone on systolic cardiac function according to quantitative and Doppler echocardiography in healthy postmenopausal women

OBJECTIVE: Our goal was to investigate the short-term and intermediate effe cts of low-dose hormone replacement therapy on echocardiographic parameters of cardiac function in healthy postmenopausal women. STUDY DESIGN: In a prospective, controlled study 30 healthy postmenopausal women (mean age, 52 +/- 3 years) were randomly assigned to 2 groups. Women in the hormone replacement therapy group (n = 15) received 1 mg micronized 17 beta -estradiol daily sequentially combined with 5 or 10 mg dydrogestero ne for 14 days of each 28-day cycle during 12 months and thereafter 2 mg 17 beta -estradiol combined with 10 mg dydrogesterone for a period of 3 month s. The control group (n = 15) received no treatment. M-mode, quantitative 2 -dimensional, and Doppler echocardiographic measurements were performed at baseline and within the 17 beta -estradiol phase at 3, 12, and 15 months. RESULTS: After 12 months significant differences in change between the 2 gr oups were found for left ventricular end-diastolic and left ventricular end -systolic diameters, left ventricular mass index, and stroke volume index. These differences were caused by changes in the control group rather than i n the hormone replacement therapy group, in which no significant within-gro up changes were found. Ail other parameters measured showed no effect. CONCLUSION: Within 15 months of 17 beta -estradiol and dydrogesterone treat ment no clinically relevant differences were found in the M-mode, quantitat ive 2-dimensional, and Doppler echocardiographic parameters measured in thi s study. It is suggested that 15 months of treatment probably is too short a period for detection of direct effects on the heart itself.