title: B-type natriuretic peptide after hormone therapy in postmenopausal women with chest pain and normal coronary angiogram.
abstract: OBJECTIVE
  Coronary heart disease is relatively uncommon in premenopausal women but shows a sharp increase after menopause. The decline of endogenous ovarian hormones is commonly assumed to be a major component of this phenomenon. The effects of estrogens on the vasculature have been investigated extensively in previous studies. However, the effects of estrogens on myocardial function have not been evaluated in humans. We sought to examine the effects of hormone therapy (HT) on myocardial function and cardiac natriuretic peptides in postmenopausal women with chest pain and a normal coronary angiogram.
  
  
  METHODS
  Transdermal HT (estradiol: 0.72 mg/2 d) was administered to 15 postmenopausal women with chest pain and a normal coronary angiogram (mean age, 53 y) for 12 weeks, and oral HT (conjugated equine estrogens: 0.625 mg/d) was administered to another 15 postmenopausal women (mean age, 54 y) for 12 weeks. Echocardiography or cardiac catheterization showed no cardiac dysfunction in any woman at baseline. Cardiac function was evaluated by echocardiography, and plasma B-type natriuretic peptide was measured every 4 weeks.
  
  
  RESULTS
  B-type natriuretic peptide levels increased after transdermal HT (baseline: 13.1 +/- 3.1, 4 wk: 22.1 +/- 2.9, 8 wk: 33.2 +/- 3.1, 12 wk: 38.4 +/- 3.3 pg/mL; P < 0.01 vs baseline). The levels were also augmented after oral HT (baseline: 14.1 +/- 3.8, 4 wk: 23.2 +/- 3.3, 8 wk: 35.6 +/- 3.9, 12 wk: 39.6 +/- 3.5 pg/mL; P < 0.01 vs baseline). Serial echocardiography showed no changes in ventricular function in either treatment group. At baseline the serum estradiol levels in the transdermal group were comparable with those in the oral group.
  
  
  CONCLUSIONS
  The estradiol levels after HT increased in both groups, but there was no significant difference between the two groups. B-type natriuretic peptide levels increased without cardiac dysfunction, and the chest symptoms were relieved in some participants after HT. Thus, estrogen supplementation augments natriuretic peptide levels without harmful effects on ventricular function.
authors: Department of Cardiovascular Medicine, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan. koumei@gpo.kumamoto-u.ac.jp
authors: Hiroaki
authors: H
authors: Kawano
authors: Yasuhiro
authors: Y
authors: Nagayoshi
authors: Hirofumi
authors: H
authors: Soejima
authors: Yasuaki
authors: Y
authors: Tanaka
authors: Jun
authors: J
authors: Hokamaki
authors: Shinzo
authors: S
authors: Miyamoto
authors: Yuji
authors: Y
authors: Miyazaki
authors: Hiroshige
authors: H
authors: Yamabe
authors: Hisao
authors: H
authors: Ogawa
mesh_terms: D000279:Administration, Cutaneous; D000284:Administration, Oral; D002637:Chest Pain / Q000097:blood / Q000188:drug therapy*; D017023:Coronary Angiography; D004452:Echocardiography; D004958:Estradiol / Q000008:administration & dosage / Q000494:pharmacology; D015914:Estrogen Replacement Therapy; D004967:Estrogens / Q000008:administration & dosage / Q000494:pharmacology; D005260:Female; D006801:Humans; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage / Q000494:pharmacology; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000187:drug effects*; D017698:Postmenopause / Q000187:drug effects*; D016276:Ventricular Function / Q000187:drug effects*
chemical_list: D004967:Estrogens; D020097:Natriuretic Peptide, Brain; D004958:Estradiol; D017258:Medroxyprogesterone Acetate