Short-term oral estrogen replacement therapy does not augment endothelium-independent myocardial perfusion in postmenopausal women

Citation
Lr. Peterson et al., Short-term oral estrogen replacement therapy does not augment endothelium-independent myocardial perfusion in postmenopausal women, AM HEART J, 142(4), 2001, pp. 641-647
Citations number
33
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Journal title
AMERICAN HEART JOURNAL
ISSN journal
00028703 → ACNP
Volume
142
Issue
4
Year of publication
2001
Pages
641 - 647
Database
ISI
SICI code
0002-8703(200110)142:4<641:SOERTD>2.0.ZU;2-C
Abstract
Objectives Th. purpose of this study was to determine the effect of usual-d ose estrogen replacement therapy (ERT) on myocardial perfusion and myocardi al perfusion reserve (MPR) (evoked by an endothelium-independent vasodilato r) in healthy postmenopausal women. Postmenopausal women have a decreased m yocardial perfusion reserve compared with younger women. Estrogen infusions are known to enhance endothelium-dependent vasodilation of the epicardial coronary arteries in postmenopausal women, but whether ERT also enhances en dothelium-independent myocardial perfusion and perfusion reserve is unclear . Methods In 2.4 healthy postmenopausal women who were not taking ERT, myocar dial perfusion at rest, perfusion during the infusion of adenosine (a prima rily endothelium-independent vasodilator), and MPR were determined by posit ron-emission tomography (PET) and oxygen 15-labeled water. The women were t hen randomly assigned in a double-blind fashion to receive either 0.625 mg of oral conjugated estrogens (Premarin) or placebo per day for 4 to 6 weeks , after which they underwent a repeat cardiac PET study. Results There was no statistical difference between those assigned to ERT a nd those assigned to placebo in the measurement of myocardial perfusion at rest (1.21 +/- 0.31 vs 1.16 +/- 0.18 mL/g/min, respectively) in response to adenosine (2.66 +/- 0.96 vs 3.3 +/- 0.45 mL/g/min) or MPR (2.24 +/- 0.83 v s 2.88 +/- 0.64 mL/g/min) after 4 to 6 weeks of oral ERT. There was also no difference between the groups in any of the myocardial perfusion measureme nts after correction for the rate-pressure product. Conclusions Short-term oral ERT does not affect myocardial perfusion at res t in response to adenosine or MPR in healthy postmenopausal women. Thus pot ential beneficial effects of ERT on vasomotor function may be limited to en hancement of endothelium-dependent vasodilative mechanisms affecting condui t vessels.