title: Short-term estrogen administration improves abnormal endothelial function in women with systemic sclerosis and Raynaud's phenomenon.
abstract: BACKGROUND
  Morphologic changes of the vascular endothelium are common in patients with systemic sclerosis and Raynaud's phenomenon. The aim of this study was to evaluate the endothelium-dependent vasodilatation and endothelium-independent vasodilatation and to examine the effects of short-term estrogen administration on vascular responses in these patients.
  
  
  RESULTS
  The study included 12 female patients with systemic sclerosis and Raynaud's phenomenon (aged 49+/-14 years) and 12 age- and sex-matched healthy control subjects. With the use of high-resolution ultrasound imaging, brachial artery diameter was measured at rest, during reactive hyperemia (endothelium-dependent response), and after administration of sublingual nitroglycerin (endothelium-independent dilatation). Intima-media thickness of the common carotid artery was also measured. Baseline diameter was similar in patients and control subjects; intima-media thickness was significantly higher in patients (0.83+/-0.3 vs 0.46+/-0.2 mm, P= .002) than in control subjects. Flow-mediated dilatation was reduced in patients (3.6%+/-7% vs 11.9%+/- 4.6%, P = .003); endothelium-independent dilatation also was reduced in patients with Raynaud's phenomenon (14%+/-7% vs 23%+/-6%, P= .003). Vascular responses in 10 patients were examined 15 minutes after administration of conjugated estrogens (25 mg intravenously); there was a significant increase of endothelium-dependent dilatation after estrogen administration (1.7%+/-4% to 6.3%+/-4%, P= .01), whereas endothelium-independent dilatation did not change (13.4%+/-8% to 15.5%+/-7%, not significant).
  
  
  CONCLUSIONS
  Endothelium-dependent vasodilatation and endothelium-independent vasodilatation are impaired in patients with Raynaud's phenomenon secondary to systemic sclerosis, whereas intima-media thickness is increased. Short-term estrogen administration can improve endothelial dysfunction in this group of patients.
authors.affiliation: Department of Clinical Therapeutics, Alexandra University Hospital, Athens, Greece.
authors.forename: J
authors.initials: J
authors.lastname: Lekakis
authors.forename: M
authors.initials: M
authors.lastname: Mavrikakis
authors.forename: C
authors.initials: C
authors.lastname: Papamichael
authors.forename: S
authors.initials: S
authors.lastname: Papazoglou
authors.forename: O
authors.initials: O
authors.lastname: Economou
authors.forename: I
authors.initials: I
authors.lastname: Scotiniotis
authors.forename: K
authors.initials: K
authors.lastname: Stamatelopoulos
authors.forename: C
authors.initials: C
authors.lastname: Vemmos
authors.forename: S
authors.initials: S
authors.lastname: Stamatelopoulos
authors.forename: S
authors.initials: S
authors.lastname: Moulopoulos
mesh_terms: D000328:Adult; D000368:Aged; D001916:Brachial Artery / Q000000981:diagnostic imaging; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D016022:Case-Control Studies; D004334:Drug Administration Schedule; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000503:physiopathology*; D004966:Estrogens, Conjugated (USP) / Q000627:therapeutic use*; D005260:Female; D006728:Hormones / Q000627:therapeutic use*; D006801:Humans; D008875:Middle Aged; D011928:Raynaud Disease / Q000000981:diagnostic imaging / Q000188:drug therapy*; D012595:Scleroderma, Systemic / Q000000981:diagnostic imaging / Q000188:drug therapy*; D014463:Ultrasonography; D014664:Vasodilation / Q000187:drug effects*
chemical_list: D004966:Estrogens, Conjugated (USP); D006728:Hormones