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-estradiol on ventricular and vascular
hemodynamics in postmenopausal women
1 Department of Cardiology, St. Vincent's Hospital, Sydney 2010, Australia; and 2 Department of Cardiac Medicine, National Heart and Lung Institute, Imperial College, London SW3 6LY, United Kingdom
Because premenopausal
women have lower cardiovascular morbidity than postmenopausal women, it
has been proposed that estrogen may have a protective role. Estrogen is
involved in smooth muscle relaxation both through its specific receptor
as well as through calcium channel blockade. This study examined the
acute effect of estradiol on invasive cardiovascular hemodynamics in 18 postmenopausal women (age 62.6 ± 7.6 years, means ± SD).
The effect of estradiol on left ventricular chamber performance was
studied in 9 women using simultaneous left ventricular pressure-volume
recordings. In a further group of 9 women, the acute effect of
estradiol on arterial function was assessed using input impedance
(derived from simultaneous aortic pressure and flow recordings),
pressure waveform analysis, and pulse wave velocity. After 2 mg
micronized 17
-estradiol was administered, serum estradiol levels
increased from 50.9 ± 21.9 to 3,190 ± 2,216 pmol/l,
P < 0.0001. There was no effect of estradiol on either
left ventricular inotropic or lusitropic function. There was no acute
effect of estradiol on arterial impedance, reflection coefficient,
augmentation index, or pulse wave velocity. There was a trend to
decreased heart rate and cardiac output in both groups of 9 women.
Because heart rate and cardiac output were common to both hemodynamic
data sets, results for these parameters were pooled. Across all 18 women, there was a small but significant decrease in heart rate
(69.2 ± 10.4 vs. 67.2 ± 9.9 beats/min, P = 0.02), as well as a significant decrease in cardiac output (4.82 ± 1.77 vs. 4.17 ± 1.56 l/min, P = 0.002).
Despite achieving supraphysiological serum levels, this study found no
significant effect of acute 17
-estradiol on ventricular or large
artery function.
estrogen; arterial compliance; pressure-volume study; aortic impedance
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