title: Acute effects of 17beta-estradiol on left internal mammary graft after coronary artery bypass grafting.
abstract: BACKGROUND
  Vasospasm of arterial conduits used for coronary surgical procedures is an important cause of postoperative graft failure. Mounting experimental evidence suggests that estrogen reverses acetylcholine-induced vasospasm of the coronary arteries in animals and humans. Estrogen also affects endothelium-derived constrictor factors. We therefore investigated the in vivo vasomotor responses to transdermal 17beta-estradiol of the left internal mammary artery (LIMA) grafted on the anterior descending coronary artery.
  
  
  METHODS
  We studied 20 women, mean age of 62 +/- 7.2 years (range, 48 to 73 years), who had undergone cardiopulmonary bypass for coronary artery bypass grafting. They received transdermal 17beta-estradiol on the fifth day after operation. The diameter, cross-sectional area, and blood flow of the LIMA graft were measured by transthoracic color Doppler echography before (basal values) and after the transdermal administration of 50 microg of 17beta-estradiol (control).
  
  
  RESULTS
  LIMA graft vasodilation after the administration of 17beta-estradiol was observed. A significant increase in diameter (2.06 +/- 0.4 mm versus 2.37 +/- 0.28 mm; p = 0.035) and cross-sectional area (3.45 +/- 1. 2 mm2 versus 4.24 +/- 1 mm2; p = 0.039) was registered. The LIMA graft mean flow increased by 49% (44.76 +/- 27.19 mL/min versus 56.62 +/- 27.69 mL/min), but this increase was not statistically significant (p = 0.06).
  
  
  CONCLUSIONS
  The acute postoperative transdermal administration of 17beta-estradiol induced a significant increase of LIMA graft diameter and cross-sectional area in postmenopausal women who underwent coronary artery bypass grafting. The LIMA graft vasodilation was also associated with an improvement in LIMA blood flow.
authors.affiliation: Department of Cardiac Surgery, University of Milan, Centro Cardiologico Monzino IRCCS, Italy. luca.polvani@cardiologicomonzino.it
authors.forename: Gianluca
authors.initials: G
authors.lastname: Polvani
authors.forename: Maria Rosa
authors.initials: MR
authors.lastname: Marino
authors.forename: Maurizio
authors.initials: M
authors.lastname: Roberto
authors.forename: Luca
authors.initials: L
authors.lastname: Dainese
authors.forename: Alessandro
authors.initials: A
authors.lastname: Parolari
authors.forename: Giulio
authors.initials: G
authors.lastname: Pompilio
authors.forename: Silvia
authors.initials: S
authors.lastname: Di Matteo
authors.forename: Andrea
authors.initials: A
authors.lastname: Fumero
authors.forename: Aldo
authors.initials: A
authors.lastname: Cannata
authors.forename: Fabio
authors.initials: F
authors.lastname: Barili
authors.forename: Paolo
authors.initials: P
authors.lastname: Biglioli
mesh_terms: D000279:Administration, Cutaneous; D000368:Aged; D001026:Coronary Artery Bypass / Q000379:methods*; D003329:Coronary Vasospasm / Q000000981:diagnostic imaging / Q000188:drug therapy*; D018618:Echocardiography, Doppler, Color; D004958:Estradiol / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000379:methods*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D014664:Vasodilation / Q000187:drug effects
chemical_list: D004958:Estradiol