Does sublingual 17β-oestradiol have any effects on exercise capacity and myocardial ischaemia in post-menopausal women with stable coronary artery disease?

被引:14
作者
Al-Khalili, F
Landgren, BM
Eksborg, S
Franco-Cereceda, A
Schenck-Gustafsson, K
机构
[1] Karolinska Hosp, Dept Cardiol, Thorac Clin, S-17176 Stockholm, Sweden
[2] Karolinska Hosp, Dept Thorac Surg, S-17176 Stockholm, Sweden
[3] Karolinska Hosp, Karolinska Pharm, S-17176 Stockholm, Sweden
[4] Karolinska Hosp, Dept Woman & Child Hlth, S-17176 Stockholm, Sweden
[5] Karolinska Inst, Stockholm, Sweden
关键词
17; beta-oestradiol; endothelin-1; exercise test; coronary artery disease; post-menopausal women;
D O I
10.1053/euhj.1998.0975
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background A variety of vascular effects have been ascribed to 17 beta-oestradiol. These effects may partially explain the reduced incidence of cardiovascular disease found in post-menopausal women on oestrogen replacement therapy. Objectives To evaluate the effects of 2 mg sublingual 17 beta-oestradiol on exercise capacity, exercise-induced myocardial ischaemia and circulating levels of endothelin-1 in post-menopausal women with stable coronary artery disease. Methods Twelve post-menopausal women, mean age 61 (range 52-72) years, with angiographically verified significant coronary artery disease, were randomly assigned to 2 mg of sublingual 17 beta-oestradiol, 2.5 mg of buccal nitroglycerine and to placebo in a double-blind cross-over study design with at least 2 days between each of the study arms. Antianginal medications, with the exception of betablockers, were discontinued before investigation. All study patients underwent a maximal bicycle exercise test 30 min after drug intake. Blood was withdrawn immediately before and up to 8 h after medication for analyses of circulating levels of oestradiol and endothelin-1. Results The mean serum levels of oestradiol increased from a control level of 72 +/- 28 pmol . l(-1) to 3557 +/- 1631 pmol . l(-1)' after 30 min and to 5028 +/- 3971 pmol . l(-1) after 60 min with a gradual decline thereafter. Sublingual 17 beta-oestradiol did not induce any improvement in exercise duration when compared with nitroglycerin and placebo (500 +/- 112 s, 505 +/- 107 s, 498 +/- 157 s), and did not influence time to onset of ST-segment depression (358 +/- 89 s, 436 +/- 93 s: 384 +/- 116 s). The plasma levels of endothelin-l did not change after administration of 17 beta-oestradiol, nitroglycerin or placebo. Conclusions No effects on exercise capacity, exercise-induced acute ischaemia, or plasma levels of endothelin-1 were found after a single dose of 2 mg 17 beta-oestradiol in post-menopausal women with documented coronary artery disease.
引用
收藏
页码:1019 / 1026
页数:8
相关论文
共 32 条
  • [1] Barrett-Connor E, 1993, Clin Geriatr Med, V9, P57
  • [2] CARDIOVASCULAR MORTALITY AND NONCONTRACEPTIVE USE OF ESTROGEN IN WOMEN - RESULTS FROM THE LIPID RESEARCH CLINICS PROGRAM FOLLOW-UP-STUDY
    BUSH, TL
    BARRETTCONNOR, E
    COWAN, LD
    CRIQUI, MH
    WALLACE, RB
    SUCHINDRAN, CM
    TYROLER, HA
    RIFKIND, BM
    [J]. CIRCULATION, 1987, 75 (06) : 1102 - 1109
  • [3] ESTROGEN RELAXES HUMAN EPICARDIAL CORONARY-ARTERIES THROUGH NON-ENDOTHELIUM-DEPENDENT MECHANISMS
    CHESTER, AH
    JIANG, CW
    BORLAND, JA
    YACOUB, MH
    COLLINS, P
    [J]. CORONARY ARTERY DISEASE, 1995, 6 (05) : 417 - 422
  • [4] NITRIC-OXIDE ACCOUNTS FOR DOSE-DEPENDENT ESTROGEN-MEDIATED CORONARY RELAXATION AFTER ACUTE ESTROGEN WITHDRAWAL
    COLLINS, P
    SHAY, J
    JIANG, CW
    MOSS, J
    [J]. CIRCULATION, 1994, 90 (04) : 1964 - 1968
  • [5] 17-BETA-ESTRADIOL ATTENUATES ACETYLCHOLINE-INDUCED CORONARY ARTERIAL CONSTRICTION IN WOMEN BUT NOT MEN WITH CORONARY HEART-DISEASE
    COLLINS, P
    ROSANO, GMC
    SARREL, PM
    ULRICH, L
    ADAMOPOULOS, S
    BEALE, CM
    MCNEILL, JG
    POOLEWILSON, PA
    [J]. CIRCULATION, 1995, 92 (01) : 24 - 30
  • [6] CARDIOVASCULAR PROTECTION BY ESTROGEN - A CALCIUM-ANTAGONIST EFFECT
    COLLINS, P
    ROSANO, GMC
    JIANG, CW
    LINDSAY, D
    SARREL, PM
    POOLEWILSON, PA
    [J]. LANCET, 1993, 341 (8855) : 1264 - 1265
  • [7] EFFECTS OF ESTROGEN REPLACEMENT THERAPY ON PERIPHERAL VASOMOTOR FUNCTION IN POSTMENOPAUSAL WOMEN
    GILLIGAN, DM
    BADAR, DM
    PANZA, JA
    QUYYUMI, AA
    CANNON, RO
    [J]. AMERICAN JOURNAL OF CARDIOLOGY, 1995, 75 (04) : 264 - 268
  • [8] EFFECTS OF PHYSIOLOGICAL LEVELS OF ESTROGEN ON CORONARY VASOMOTOR FUNCTION IN POSTMENOPAUSAL WOMEN
    GILLIGAN, DM
    QUYYUMI, AA
    CANNON, RO
    JOHNSON, GB
    SCHENKE, WH
    [J]. CIRCULATION, 1994, 89 (06) : 2545 - 2551
  • [9] EFFICACY OF SUSTAINED-RELEASE BUCCAL NITROGLYCERIN IN PATIENTS WITH ANGINA-PECTORIS - NEW AND LONG-ACTING THERAPY DEMONSTRATED BY EXERCISE
    GREENGART, A
    LICHSTEIN, E
    HOLLANDER, G
    BOLTON, S
    SANDERS, M
    [J]. CHEST, 1983, 83 (03) : 473 - 479
  • [10] beta-estradiol, but not alpha-estradiol, reduces myocardial necrosis in rabbits after ischemia and reperfusion
    Hale, SL
    Birnbaum, Y
    Kloner, RA
    [J]. AMERICAN HEART JOURNAL, 1996, 132 (02) : 258 - 262