The effect of oestrogen and progestogen replacement therapy on systolic flow velocity in healthy postmenopausal women

Prelević, Gordana M.; Beljic, Teodora

doi:10.1016/0378-5122(94)90099-x

Cited by 35 publications

(14 citation statements)

References 23 publications

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“…In accordance with the results of previous studies, [4][5][6][17][18][19] these preliminary results, which were obtained by new techniques, demonstrate that menopause influences LV functions. Previous studies have shown that improvement, particularly in LV diastolic functions, was noted by HRT.…”

Section: Circulation Journal Vol71 November 2007supporting

confidence: 80%

“…5,6 Prelevic et al have also demonstrated that EF and aortic flow velocities are lower in postmenopausal women than in premenopausal women. 17 The significant age difference between pre-and postmenopausal women in these studies have caused dispute among investigators as to whether these cardiac structural and functional changes are related to aging or menopause. Evaluation of the effects of menopause on cardiac structures and functions in agematched pre-and postmenopausal women were performed in only 2 studies.…”

Section: Discussionmentioning

confidence: 99%

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Effects of Menopause on the Myocardial Velocities and Myocardial Performance Index

Düzenli

Özdemi̇r

Sökmen

et al. 2007

Circ J

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enopause is a critical period in a woman's life, during which many physiologic and pathologic changes occur. Women spend one-third of their lifetime in this period and the hormonal changes that occur during this period have significant influences on several organs and systems. The cardiovascular system is among the most dramatically affected systems. Changes in cardiovascular risk factors due to estrogen deficiency and subsequent increase in cardiovascular morbidity and mortality have been demonstrated in several studies. [1][2][3] Structural and functional changes in the heart can also occur during the postmenopausal period. The effects of menopause on cardiac structure and function have not been investigated adequately. Interpretation of the results of the few previous studies 4-6 comparing pre-and postmenopausal women comprises some difficulties, owing to significant age differences and small sample sizes. Moreover, cardiac functions have been evaluated only by conventional 2-dimensional (D) and M-mode echocardiography in these studies, thus the extent of influence on more recent echocardiographic parameters after menopause have not been adequately analyzed.Tissue Doppler echocardiography (TDE) is a relatively new technique, which is partially utilized in recent years to evaluate cardiac functions via measurement of myocardial velocities. 7 Also, myocardial performance index (MPI) has been recognized as a parameter that reflects ventricular systolic and diastolic functions. 8,9 To our knowledge, no literature exists on how myocardial velocities, as measured by TDE, which have some advantages over standard echocardiographic methods, and MPI, which provides a more quantitative and global evaluation of left ventricular (LV), are affected by menopause. The present study was designed to investigate how myocardial velocities measured by TDE and MPI, which together provide more quantitative data on regional and global ventricular functions, are affected by menopause. Methods Study PopulationSubjects were selected from healthy women admitted to the gynecology and obstetrics, and cardiology outpatient departments between 2001 and 2006. After informed consent was obtained, a prospective analysis was performed. Body weight and height of all subjects were measured and body mass index was calculated. Fasting blood samples were drawn for biochemical and hematological investigations and ECGs were done. An exercise stress test using Bruce protocol and subsequent echocardiographic evaluations were performed. Postmenopausal status was confirmed as being in menopause for at least 12 months with serum follicle-stimulating hormone (FSH) levels of >30 mU/ml and estrogen levels of <20 pg/ml, and premenopausal status Effects of Menopause on the Myocardial Velocities and Myocardial Performance IndexMehmet Akif Düzenli, MD; Kurtulus Ozdemir, MD; Abdullah Sokmen, MD**; Ahmet Soylu, MD; Nazif Aygul, MD; Kazim Gezginc, MD*; Mehmet Tokac, MD Background Although menopause is known to increase cardiovascular risk and mortality, the effect ...

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Section: Circulation Journal Vol71 November 2007supporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Effects of Menopause on the Myocardial Velocities and Myocardial Performance Index

Düzenli

Özdemi̇r

Sökmen

et al. 2007

Circ J

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“…Expression of both estrogen and progesterone receptors in myocytes indicated a direct effect of the hormones on myocardial function (14, 18). Studies of postmenopausal women using echocardiography have demonstrated significant decreases in cardiac contractility compared with those of premenopausal women (23,24). Reductions in stroke work and fractional shortening have also been demonstrated in studies using whole heart preparations of ovariectomized rats (28).…”

mentioning

confidence: 97%

Regulatory role of ovarian sex hormones in calcium uptake activity of cardiac sarcoplasmic reticulum

Bupha-Intr

Wattanapermpool²

2006

American Journal of Physiology-Heart and Circulatory Physiology

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Bupharesponsiveness, was demonstrated in ovariectomized hearts. In parallel measurements of SERCA activity in SR-enriched membrane preparations from ovariectomized hearts, a suppressed maximum SERCA activity with a leftward shift in the relationship between pCa (-log molar free Ca 2ϩ concentration) and SERCA activity was also detected. A significant downregulation of SERCA proteins and reduction in the SERCA mRNA level were observed in association with suppressed maximum SERCA activity. While there were no changes in total phospholamban and phosphorylated Ser 16 phospholamban levels, a decrease in phosphorylated Thr 17 phospholamban as well as an increase in the suprainhibitory, monomeric form of phospholamban stoichiometry was found. Estrogen and progesterone supplementations were equally effective in preventing changes in ovariectomized hearts. Our data showed for the first time that female sex hormones played an important role in the regulation of the cardiac SR Ca 2ϩ uptake. Under hormone-deficient conditions, there was an adaptive response of SERCA that escaped the regulatory effect of phospholamban. sarcoplasmic reticulum Ca 2ϩ -adenosine 5Ј-triphosphate activity; phospholamban; phosphorylation THE CARDIOREGULATORY ROLE of female sex hormones in contractile activity has been raised in many studies (23, 24, 28, 34 -36). Expression of both estrogen and progesterone receptors in myocytes indicated a direct effect of the hormones on myocardial function (14, 18). Studies of postmenopausal women using echocardiography have demonstrated significant decreases in cardiac contractility compared with those of premenopausal women (23,24). Reductions in stroke work and fractional shortening have also been demonstrated in studies using whole heart preparations of ovariectomized rats (28). In addition, suppression of both myosin ATPase activity and maximum myofibrillar ATPase activity with an upregulation of ␤-myosin heavy chain in ovariectomized rat hearts was reported (28,34,35). All evidence indicated important roles of female sex hormones in myocardial activation. The striking finding was an increase in the Ca 2ϩ responsiveness of cardiac myofilament activation with almost the same magnitude in ovariectomized hearts as that in cardiomyopathic failing hearts (17,34,35,38,39). The information thus implied a potential of cardiomyopathic induction by female sex hormone deficiency. It was, however, not known how myofilament Ca 2ϩ hypersensitivity was induced in the hormone-deficient heart. A reasonable hypothesis was that this effect may be an adaptive response of the heart to changes in the intracellular free Ca 2ϩ

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“…For instance, whether inotropic effects observed after short-term HRT administration 42 differ in younger and older women has not been demonstrated. In addition, it has not been addressed whether the short-term cardiac effects of HRT described above may somehow be responsible for the observation that the difference between treatment groups in coronary heart disease hazards is apparent soon after randomization.…”

Section: Age Of Initiation Of Hrtmentioning

confidence: 99%

“…40 Hemodynamic changes may differ for shortterm and long-term HRT administration. For instance, echocardiographic studies have suggested either no effect of estrogen replacement therapy on cardiac function 41 or a positive inotropic effect, 42 which would tend to increase rather than reduce SBP. More recently, a study using invasive left ventricular and aortic function evaluation found that acute estrogen administration did not change left ventricular ejection fraction or ejection time.…”

Section: Effect Of Hrt On Arterial Compliance and Vessel Thicknessmentioning

confidence: 99%

Blood Pressure, Arterial Function, Structure, and Aging: The Role of Hormonal Replacement Therapy in Postmenopausal Women

Scuteri

Ferrucci

2003

J of Clinical Hypertension

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2 The strength of the WHI study findings, supported by the rigorous design, the large sample size, and the long follow-up, appears to have put the word "end" to the use of HRT for prevention of CVD in postmenopausal women.We have neither the authority nor clear evidence to provide an alternative approach to the statement reported in the paper by the WHI study investigators. However, as noted in an editorial relating to the WHI Study, 3 46 million prescriptions for conjugated estrogens (Premarin) were written in the United States in 2000. The idea that so many doctors prescribed an "inappropriate" treatment for so many years is difficult to accept.For example, increasing attention should be paid to exploring criteria that could be used for a greater individualization of HRT prescriptions for postmenopausal women and better-characterized risk factor profiles that would identify postmenopausal women who are most likely to benefit from specific HRT in terms of cardiovascular protection.The results of this clinical trial are certainly true for oral HRT administration, but current clinical practices are often based on transdermal administration. Some preliminary data suggest that the two treatment approaches may not be equivalent.The goal of the present manuscript is to very briefly underline some issues still to be addressed with regard to the effects of HRT on large artery

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The effect of oestrogen and progestogen replacement therapy on systolic flow velocity in healthy postmenopausal women

Cited by 35 publications

References 23 publications

Effects of Menopause on the Myocardial Velocities and Myocardial Performance Index

Effects of Menopause on the Myocardial Velocities and Myocardial Performance Index

Regulatory role of ovarian sex hormones in calcium uptake activity of cardiac sarcoplasmic reticulum

Blood Pressure, Arterial Function, Structure, and Aging: The Role of Hormonal Replacement Therapy in Postmenopausal Women

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