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Beneficial long-term effect of hormone replacement therapy on coronary vasomotion in postmenopausal women with treated coronary risk factors

¹ Internal Medicine, Nuclear Cardiology and Cardiovascular Center, Geneva, Geneva, Switzerland; ² Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, Nuclear Medicine, Los Angeles, California

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Objectives: To evaluate the effect of hormone replacement therapy (HRT) on coronary vasomotion in postmenopausal women (PM) with treated coronary risk factors.

Methods: Myocardial blood flow (MBF) was measured with N-13 ammonia PET at rest and during vasomotor stress. Twelve premenopausal women studied at baseline served as controls (CON). In PM (n=48), MBF was evaluated again after a mean follow-up (FU) of 24±14 months. PM were grouped according to HRT: group 1 (n=18) with HRT, group 2 without HRT (n=18) and group 3 with HRT at baseline but not at FU (n=12).

Results: Hyperemic MBF was significantly lower in PM with HRT and without HRT than in CON (1.59±0.54 and 1.73±0.41 vs. 2.35±0.56 ml/g/min; p<0.01). The endothelium-related increase in MBF (MBF) to cold pressor test (CPT) tended to be higher in CON than in PM with HRT (0.35±0.23 vs. 0.24±0.20 ml/g/min, p=0.17), while it was significantly less in PM without HRT (0.16±0.12 vs. 0.35±0.23 ml/g/min, p<0.02). Hyperemic MBFs at FU were not different from those at baseline in group 1-3. At FU, in group 2 and 3 the MBF to CPT was significantly less than at baseline (0.05±0.19 vs. 0.16±0.12 and -0.03±0.14 vs. 0.25±0.18 ml/g/min; p<0.02)(Fig.). In contrast, in group 1, MBF at FU did not differ significantly from that at baseline (0.19±0.22 vs. 0.23±0.22 ml/g/min, p=0.45). The group comparison of MBF in group 2 and 3 after the FU period was different from group 1 (p<0.0001 by ANOVA).

Conclusions: Long-term administration of estrogen exert beneficial effects on endothelium-dependent coronary vasomotion in young postmenopausal women, even when coronary risk factors are treated.

This Article Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Schindler, T. Articles by Schelbert, H. PubMed Articles by Schindler, T. Articles by Schelbert, H.