Acute and chronic effects of oestradiol on left ventricular diastolic function in hypertensive postmenopausal women with left ventricular diastolic dysfunction

• Published in: Heart (British Cardiac Society) Vol. 90; no. 7; pp. 777 - 781
• Main Authors: Alecrin, I N, Aldrighi, J M, Caldas, M A, Gebara, O C E, Lopes, N H M, Ramires, J A F
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and British Cardiovascular Society 01.07.2004; BMJ; BMJ Publishing Group LTD; Copyright 2004 by Heart
• Subjects: Adult; Age; Aged; American Society of Echocardiography; and treatment of high blood pressure; Arterial hypertension. Arterial hypotension; ASE; atrial flow reversal; Biological and medical sciences; Blood and lymphatic vessels; Blood Flow Velocity; Blood Pressure - drug effects; Body Mass Index; Cardiology. Vascular system; Cardiovascular disease; Cardiovascular Medicine; Clinical manifestations. Epidemiology. Investigative techniques. Etiology; Coronary vessels; deceleration time of the E wave; detection; Diastole; diastolic dysfunction; Doppler echocardiography; Double-Blind Method; DTE; Estradiol - administration & dosage; Estradiol - pharmacology; evaluation; Female; follicle stimulating hormone; FSH; Health risk assessment; heart and estrogen/progestin replacement study; Heart failure; Heart Rate - drug effects; HERS; Hormone replacement therapy; HRT; Humans; Hypertension; Hypertension - complications; Hypertension - physiopathology; isovolumic relaxation time; IVRT; JNC; Joint National Committee on prevention; Medical sciences; Menopause; Middle Aged; Mortality; Observer Variation; oestradiol; Osteoporosis; peak velocity of diastolic pulmonary venous flow; peak velocity of early diastolic filling; peak velocity of late diastolic filling; peak velocity of mitral A wave; peak velocity of mitral E wave; peak velocity of systolic pulmonary venous flow; Physiology; postmenopausal women; Postmenopause - drug effects; Prospective Studies; Studies; Ultrasonography, Doppler; vel a; Vel E; Ventricular Dysfunction, Left - drug therapy; Ventricular Dysfunction, Left - physiopathology; Ventricular Function, Left - drug effects; WHI; Womens health; women’s health initiative; Human; Hypertension; Chronic; Acute; Postmenopause; Cardiovascular disease; Circulatory system; Cardiology; Woman; Left ventricle performance; Estradiol; Phlebology
• ISSN: 1355-6037; 1468-201X
• DOI: 10.1136/hrt.2003.016493

Background: Left ventricular function changes in the postmenopausal state. However, there are conflicting reports about the effects of oestrogen on left ventricular diastolic function in postmenopausal women. Objective: To evaluate the acute and chronic effects of oestradiol in physiological doses on diastolic heart function in hypertensive postmenopausal women with left ventricular diastolic dysfunction. Methods: A prospective, randomised, double blind, placebo controlled study was used to evaluate the effects of oestradiol in 34 hypertensive women with left ventricular dysfunction. The acute effects of a single 1 mg oral dose of oestradiol or placebo were determined after 90 minutes. The chronic effects of 1 mg oestradiol orally/day or placebo were determined after 12 weeks. Diastolic functional indices (mitral flow and pulmonary venous flow) were assessed by Doppler echocardiography. Results: Though an appropriate serum concentration was achieved, no acute effect of oestradiol administration on left ventricular diastolic function was identified. After 12 weeks of treatment the following changes (mean (SD)) were identified in the oestradiol group: a decrease in isovolumic relaxation time from 127 (23) to 106 (16) ms (p < 0.001), and in the deceleration time of the mitral E wave from 260 (42) to 238 (20) ms (p < 0.05); and an increase in the E/A ratio from 0.8 (0.2) (basal) to 1.0 (0.2) after 12 weeks (p < 0.001). Conclusions: Hypertensive postmenopausal women who had hormone replacement therapy over a period of 12 weeks had significant improvement in left ventricular diastolic function. No changes were identified following acute administration.