Short-term estrogen administration ameliorates dobutamine-induced myocardial ischemia in postmenopausal women with coronary artery disease

被引:29
作者
Alpaslan, M [1 ]
Shimokawa, H [1 ]
KuroiwaMatsumoto, M [1 ]
Harasawa, Y [1 ]
Takeshita, A [1 ]
机构
[1] KYUSHU UNIV, SCH MED, RES INST ANGIOCARDIOL & CARDIOVASC CLIN, HIGASHI KU, FUKUOKA 81282, JAPAN
关键词
D O I
10.1016/S0735-1097(97)00346-X
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives. This study was designed to examine whether short-term estrogen administration ameliorates dobutamine-induced myocardial ischemia in postmenopausal women with coronary artery disease (CAD). Background. Estrogen replacement therapy in postmenopausal women is associated with a marked reduction in the risk of CAD. Estrogen has been reported to have both short-and long-term effects on the cardiovascular system. However, it remains to be examined whether short-term estrogen administration amelio rates myocardial ischemia caused by increased myocardial oxygen demand in postmenopausal women with CAD. Methods. Eight postmenopausal women with proved CAD underwent dobutamine stress echocardiography (DSE). DSE was performed three times in a placebo-controlled, double-blind manner: 1) 30 min after intravenous administration of saline solution (placebo) and after 2) a low dose (1.25 mg) and 3) a high dose (10 mg) of conjugated estrogen. The effects of estrogen were compared at the maximal comparable stage of DSE, which was the maximal DSE level that the same patient achieved in all three examinations. Results. Estrogen dose dependently ameliorated the dobutamine induced worsening of symptoms (prolonging time to onset of symptoms by 52% [low dose] and 72% [high dose]), electrocardiographic findings (decreasing the magnitude of summed ST segment changes by 36% [low dose] and 76% [high dose]) and left ventricular wall motion (reducing the wall motion scare index by 50% [low dose] and 77% [high dose], all p < 0.01 by analysis of variance). There was no significant difference in blood pressure, heart rate or rate pressure product among the three examinations at the maximal comparable stage of DSE. Conclusions. Estrogen has short-term anti-ischemic effects on the myocardial ischemia induced by increased myocardial oxygen demand in postmenopausal women with CAD. (C) 1997 by the American College of Cardiology.
引用
收藏
页码:1466 / 1471
页数:6
相关论文
共 29 条
  • [21] In normal postmenopausal women physiologic estrogen replacement therapy fails to improve exercise tolerance: A randomized, double-blind, placebo-controlled, crossover trial
    Snabes, MC
    Herd, JA
    Schuyler, N
    Dunn, K
    Spence, DW
    Young, RL
    [J]. AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1996, 175 (01) : 110 - 114
  • [22] POSTMENOPAUSAL ESTROGEN USE AND CORONARY ATHEROSCLEROSIS
    SULLIVAN, JM
    VANDERZWAAG, R
    LEMP, GF
    HUGHES, JP
    MADDOCK, V
    KROETZ, FW
    RAMANATHAN, KB
    MIRVIS, DM
    [J]. ANNALS OF INTERNAL MEDICINE, 1988, 108 (03) : 358 - 363
  • [23] Short-term estrogen augments both nitric oxide-mediated and non-nitric oxide-mediated endothelium-dependent forearm vasodilation in postmenopausal women
    Tagawa, H
    Shimokawa, H
    Tagawa, T
    KuroiwaMatsumoto, M
    Hirooka, Y
    Takeshita, A
    [J]. JOURNAL OF CARDIOVASCULAR PHARMACOLOGY, 1997, 30 (04) : 481 - 488
  • [24] CATECHOL ESTROGENS ARE MORE POTENT ANTIOXIDANTS THAN ESTROGENS FOR THE CU2+-CATALYZED OXIDATION OF LOW OR HIGH-DENSITY-LIPOPROTEIN - ANTIOXIDATIVE EFFECTS OF STEROIDS ON LIPOPROTEINS
    TANIGUCHI, S
    YANASE, T
    KOBAYASHI, K
    TAKAYANAGI, R
    HAJI, M
    UMEDA, F
    NAWATA, H
    [J]. ENDOCRINE JOURNAL, 1994, 41 (06) : 605 - 611
  • [25] HEMODYNAMIC AND MECHANICAL DETERMINANTS OF MYOCARDIAL O-2 CONSUMPTION IN NORMAL HUMAN HEART - EFFECTS OF DOBUTAMINE
    VANOVERSCHELDE, JLJ
    WIJNS, W
    ESSAMRI, B
    BOL, A
    ROBERT, A
    LABAR, D
    COGNEAU, M
    MICHEL, C
    MELIN, JA
    [J]. AMERICAN JOURNAL OF PHYSIOLOGY, 1993, 265 (06): : H1884 - H1892
  • [26] SHORT-TERM ADMINISTRATION OF ESTROGEN AND VASCULAR-RESPONSES OF ATHEROSCLEROTIC CORONARY-ARTERIES
    WILLIAMS, JK
    ADAMS, MR
    HERRINGTON, DM
    CLARKSON, TB
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1992, 20 (02) : 452 - 457
  • [27] ESTROGEN MODULATES RESPONSES OF ATHEROSCLEROTIC CORONARY-ARTERIES
    WILLIAMS, JK
    ADAMS, MR
    KLOPFENSTEIN, HS
    [J]. CIRCULATION, 1990, 81 (05) : 1680 - 1687
  • [28] THE EFFECT OF ATHEROSCLEROSIS ON THE VASOMOTOR RESPONSE OF CORONARY-ARTERIES TO MENTAL STRESS
    YEUNG, AC
    VEKSHTEIN, VI
    KRANTZ, DS
    VITA, JA
    RYAN, TJ
    GANZ, P
    SELWYN, AP
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1991, 325 (22) : 1551 - 1556
  • [29] MODULATION OF CORONARY VASOMOTOR TONE IN HUMANS - PROGRESSIVE ENDOTHELIAL DYSFUNCTION WITH DIFFERENT EARLY STAGES OF CORONARY ATHEROSCLEROSIS
    ZEIHER, AM
    DREXLER, H
    WOLLSCHLAGER, H
    JUST, H
    [J]. CIRCULATION, 1991, 83 (02) : 391 - 401