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Published on: August 13, 2019
The effects of hormone replacement therapy on myocardial performance in early postmenopausal women
M A Duzenli1, K Ozdemir, A Sokmen
1Department of Cardiology, Selcuk University, Konya, Turkey.
Insights
Hormone replacement therapy (HRT) improves cardiovascular performance in early postmenopausal women by enhancing diastolic function and exercise capacity. This study shows HRT benefits beyond menopausal symptom relief.
Area of Science:
- Cardiology
- Endocrinology
- Women's Health
Background:
- Cardiovascular effects of hormone replacement therapy (HRT) are debated.
- Conventional echocardiography has limitations in assessing HRT's cardiac impact.
- Early postmenopausal women are a key demographic for HRT research.
Purpose of the Study:
- To investigate HRT's effects on myocardial velocities and myocardial performance index (MPI).
- To evaluate HRT's impact on cardiac function in healthy early postmenopausal women.
- To assess changes in exercise capacity following HRT.
Main Methods:
- Prospective, controlled study of 60 healthy postmenopausal women (32 HRT, 28 control).
- Tissue Doppler echocardiography measured myocardial velocities (Sm, Em, Am) and calculated MPI.
- Symptom-limited exercise stress tests (Bruce protocol) were performed.
- Examinations repeated at 3 and 6 months post-HRT initiation.
Main Results:
- HRT did not alter systolic myocardial velocities (Sm).
- HRT significantly increased diastolic myocardial velocity ratios (Em/Am) and decreased MPI at 6 months.
- HRT led to significant improvements in exercise duration and metabolic equivalents after 3 months, sustained at 6 months.
Conclusions:
- HRT improves cardiovascular performance in early postmenopausal women.
- HRT enhances diastolic function and exercise capacity.
- HRT offers benefits beyond menopausal symptom management.
Objectives:
The results of the studies in which the effect of hormone replacement therapy (HRT) on cardiac function have been evaluated are rather disputable. In these studies, cardiac function was evaluated with conventional echocardiographic methods. This study was planned in order to investigate the effects of HRT on myocardial velocities and myocardial performance index (MPI) in healthy early postmenopausal women.
Method:
In a prospective, controlled study, 60 healthy postmenopausal women were assigned to two groups (32 in the HRT group and 28 in the control group). After conventional echocardiographic parameters were measured, tissue Doppler echocardiography recordings were obtained from the mitral and tricuspid annulus. Systolic myocardial velocity (Sm), early and late diastolic myocardial velocities (Em and Am) and time intervals were measured and MPI was calculated. Then the symptom-limited exercise stress test using the Bruce protocol was performed. After 3 and 6 months of HRT (oral 0.625 mg conjugated estrogen + 2.5 mg medroxyprogesterone acetate/day), the same examinations were repeated. The effects of HRT on myocardial velocities, MPI and exercise time were evaluated at the 3rd and 6th months.
Results:
The parameters of the control group remained statistically unchanged during the study. HRT did not have any effect on segmental and mean left ventricular (LV) Sm or right ventricular (RV) Sm. However, LV Em/Am and RV Em/Am ratios significantly increased at the 6th month of HRT, and LV and RV MPI values were observed to decrease significantly as compared to basal values. Additionally, a significant increase was observed in exercise duration and metabolic equivalent values after 3 months of HRT, and this increase continued at the 6th month as well. The favorable changes in all parameters in the HRT group were significantly different from those of the control group.
Conclusion:
Data obtained in this study suggest that HRT is not only effective for treating menopausal complaints but also increases cardiovascular performance by improving especially diastolic functions in early postmenopausal women.
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