Effects of a single dose of oral estrogen on left ventricular diastolic function in hypertensive postmenopausal women with diastolic dysfunction.
OBJECTIVE
To evaluate the acute effects of a single dose of oral estrogen on left ventricular diastolic function in hypertensive postmenopausal women with diastolic dysfunction.


METHODS
Prospective, double-blind, placebo-controlled, clinical study.


METHODS
Cardiology and postmenopausal outpatient clinics of a university hospital.


METHODS
Thirty postmenopausal women with hypertension (diastolic blood pressure of >90 mm Hg) and left ventricular diastolic dysfunction (mitral E/A ratio [the ratio of peak velocity of early mitral diastolic filling to late diastolic filling] of <1 and isovolumic relaxation time of >100 ms) were included in the study. Thirty normotensive postmenopausal women with normal left ventricular diastolic function served as the control group.


METHODS
Conjugated equine estrogen (0.625 mg) was given orally. Left ventricular diastolic function was assessed by Doppler echocardiography at baseline and 3 hours after the administration of estrogen.


METHODS
Left ventricular diastolic filling as assessed by Doppler echocardiography.


RESULTS
Estrogen had no effect on heart rate or blood pressure in either study group. The baseline E/A ratios were 0.72 +/- 0.26 and 1.22 +/- 0.30, and the isovolumic relaxation times were 122 +/- 18 ms and 89 +/-14 ms in the hypertensive and normotensive groups, respectively. Estrogen had no significant effect on any of the Doppler parameters in the normotensive group. In the hypertensive group, there was a trend toward normalization of the E/A ratio (from 0.73 +/- 0.11 to 0.84 +/- 20) and a significant improvement in the isovolumic relaxation time (from 124 +/- 20 ms to 105 +/- 13 ms) in response to the administration of estrogen compared with placebo.


CONCLUSIONS
A single dose of oral estrogen caused a significant improvement in left ventricular diastolic filling in hypertensive postmenopausal women with diastolic dysfunction.
Fak
A S
AS
Department of Cardiology, Marmara University Medical School, Istanbul, Turkey.
Erenus
M
M
Tezcan
H
H
Caymaz
O
O
Oktay
S
S
Oktay
A
A
D001794:Blood Pressure / Q000187:drug effects; D003971:Diastole; D004311:Double-Blind Method; D015150:Echocardiography, Doppler; D004966:Estrogens, Conjugated (USP) / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D008875:Middle Aged; D010919:Placebos; D017698:Postmenopause; D011446:Prospective Studies; D018487:Ventricular Dysfunction, Left / Q000188:drug therapy* / Q000503:physiopathology
D004966:Estrogens, Conjugated (USP); D010919:Placebos