Author + information
- Received March 19, 1997
- Revision received September 12, 1997
- Accepted September 29, 1997
- Published online January 1, 1998.
- Mercè Roqué, MDA,
- Magda Heras, MDA,
- Eulàlia Roig, MDA,
- Mònica Masotti, MDA,
- Montserrat Rigol, DVMA,
- Amadeu Betriu, MDA,
- Juan Balasch, MDB and
- Ginés Sanz, MDA,* ()
- ↵*Dr. Ginés Sanz, Cardiovascular Institute, Hospital Clı́nic, Villarroel, 170, Barcelona, 08036 Spain.
Objectives. This study sought to analyze the effect of short-term transdermal estradiol treatment on in vivo coronary endothelial function in postmenopausal women with angina and normal results on coronary arteriograms.
Background. The incidence of coronary heart disease increases in women after menopause. Estrogen replacement therapy has been associated with a global reduction in cardiovascular disease incidence and mortality. In addition, coronary endothelial dysfunction has been demonstrated in a group of postmenopausal women. It has been shown that intravenous or intracoronary estrogens improve endothelial function in postmenopausal women with coronary atherosclerosis. However, the efficacy of this treatment is unknown in patients with angina and normal coronary arteries.
Methods. Endothelium-dependent coronary reactivity was analyzed in 15 postmenopausal women with angina and normal coronary arteries at baseline and after 24 h of estradiol transdermal administration (100 μg).
Results. Estradiol concentration increased from 22 ± 8 pg/ml (mean ± SEM) at baseline to 76 ± 13 pg/ml (p < 0.01) at 24 h. At baseline, acetylcholine induced vasoconstriction, with a mean diameter reduction of −23 ± 6% (p = 0.002). After estrogen treatment, there was no vasoconstriction with acetylcholine, with a mean diameter change of 0 ± 4%, significantly different from the pretreatment diameter reduction observed (p = 0.003). Similarly, estimated coronary blood flow significantly increased in response to acetylcholine after estrogen treatment, with a mean change of 50 ± 30% compared with 5 ± 24% before estradiol administration (p = 0.04).
Conclusions. Early after transdermal estrogen administration, endothelium-dependent coronary vasomotion is improved in postmenopausal women with angina and normal coronary arteries.
☆ This study was supported by the following grants: SAF96-0025 (Plan Nacional de Investigación Cientı́fica y Desarrollo Tecnológico); Sociedad Española de Cardiologı́a Grant for Cardiovascular Research Projects, 1995; Societat Catalana de Cardiologia (Premi d’Ajut a la Investigació 1995); Post-Residency award from the Hospital Clı́nic, Barcelona. Young Investigator Award, Scientific Conference on Hormonal, Metabolic, and Cellular influences on Cardiovascular Disease in Women, San Diego, California, October 1995.
This work was presented in part at the 69th Scientific Sessions of the American Heart Association, New Orleans, Louisiana, November 1996.
- Received March 19, 1997.
- Revision received September 12, 1997.
- Accepted September 29, 1997.
- The American College of Cardiology