The acute effects of sublingual estradiol on left ventricular diastolic function in normotensive and hypertensive postmenopausal women.
OBJECTIVE
limited information is available on estrogen influences on diastole. We aimed to investigate the acute effects of a single dose of sublingual 17beta-estradiol on left ventricular diastolic function in postmenopausal women.


METHODS
the study included 28 women aged 55.6 +/- 6 (15 normotensive and 13 hypertensive), who underwent Doppler echocardiography and estradiol plasma levels determination before and 60 min after sublingual administration of 4 mg of 17beta-estradiol.


RESULTS
there were no modifications in heart rate. Both systolic and diastolic blood pressure dropped significantly in the hypertensives and remained unchanged in normotensives. Estradiol levels were 1790 +/- 869 pg/ml in the normotensives and 2664 +/- 1490 in the hypertensives (P < 0.05). Peak early velocity, in the population as a whole, increased from 84 +/- 18 to 91 +/- 18 cm/s and the early-to-atrial velocity ratio from 1.1 +/- 0.4 to 1.4 +/- 0.6 (P < 0.0001 for both). Both acceleration and deceleration rates increased significantly (P < 0.0001). These changes were shared by all the patients. In addition, the hypertensive patients, who presented a baseline pattern characterized mainly by a grossly increased peak atrial velocity with reduction in the early-to-atrial velocity ratio, demonstrated a decrease in peak atrial velocity from 92 +/- 12 to 78 +/- 10 cm/s (P < 0.0001), associated with significant reductions in deceleration time (P < 0.0001) and pressure half time (P < 0.005). Therefore, the typical picture of impaired ventricular relaxation was favorably changed after estradiol administration.


CONCLUSIONS
the sublingual administration of estradiol induces acute modifications in left ventricular diastolic function in postmenopausal women, with improvement in the age-related left ventricular relaxation pattern, and that these beneficial changes are more pronounced in hypertensive that in normotensive women.
Fisman
E Z
EZ
Cardiac Rehabilitation Institute, Chaim Sheba Medical Center, Tel-Hashomer, Israel. zfisman@post.tau.ac.il
Tenenbaum
A
A
Shapira
I
I
Motro
M
M
Pines
A
A
D000286:Administration, Sublingual; D002979:Climacteric / Q000187:drug effects*; D003971:Diastole / Q000187:drug effects*; D015150:Echocardiography, Doppler / Q000187:drug effects; D004958:Estradiol / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008875:Middle Aged; D016277:Ventricular Function, Left / Q000187:drug effects*
D004958:Estradiol