Left ventricular diastolic function by Doppler echocardiography in relation to hormonal replacement therapy in healthy postmenopausal women

Abstract Although it is generally agreed that estrogen replacement therapy reduces cardiovascular morbidity and mortality in postmenopausal women, 1 the mechanisms of this effect are not fully understood. The estrogen-induced favorable changes in blood lipids and lipoproteins 2 are very likely of importance, but still explain less than half the reduction in mortality. 3 Short-term treatment with estrogens increases blood volume and decreases peripheral vascular resistance, 4,5 and a theoretically beneficial reduction of arterial impedance was reported very recently. 6 Furthermore, direct myocardial effects cannot be excluded, because estrogen receptors have been identified in the hearts of primates, 7 and both deprivation and replacement of sex hormones can alter left ventricular (LV) performance in female animals. 8 In this investigation, we studied LV filling by Doppler echocardiography in 2 groups of healthy postmenopausal women, 1 receiving chronic hormonal replacement therapy, and the other matched for age and the time since menopause, but without hormonal substitution.