Browsing by Author "Beljic, T. (6603356288)"

Left ventricular heart function and its response to long-term estrogen replacement therapy was assessed in 30 postmenopausal women, 20 of whom had modest to severe hot flushes and 10 of whom had never had them. Continuous transdermal estradiol was given to women who had surgically induced menopause, and a combination of transdermal estradiol and sequential medroxy-progesterone acetate was given to there who had spontaneous menopause. Left ventricular systolic and diastolic function was evaluated by complete two-dimensional M-mode and pulsed Doppler echocardiography before and after 6 and 12 months of therapy. The parameters assessed were: systolic and diastolic blood pressure, heart rate, cardiac septal and posterior wall dimensions, left ventricular end-systolic and end-diastolic dimensions and volumes, ejection fraction (EF), ejection time, peak left ventricular outflow velocity (PFV), flow velocity integral (FVI), acceleration time (AT), mean acceleration of systolic flow (MA), duration of early and late filling phase, peak velocity of the early (E) and late (A) mitral flow, and A/E velocity ratio. Although no difference in chamber and wall dimensions between flushers and non-flushers was found, women with hot flushes had lower (not significantly) EF, PFV, FVI, MA, blood pressure and heart rate before therapy. Twelve-month estrogen replacement therapy significantly reduced cardiac wall dimensions and improved systolic function in both flushers and non-flushers. However, stroke volume, EF and MA were increased whereas systolic blood pressure and heart rate were decreased more in flushers. Also, the increase in E mitral flow and decrease in A/E were more pronounced in flushers. Thus, although estrogen replacement therapy significantly improves heart function in healthy postmenopausal women, there appears to be some minor differences in response between flushers and non-flushers.

Left ventricular heart function and its response to long-term estrogen replacement therapy was assessed in 30 postmenopausal women, 20 of whom had modest to severe hot flushes and 10 of whom had never had them. Continuous transdermal estradiol was given to women who had surgically induced menopause, and a combination of transdermal estradiol and sequential medroxy-progesterone acetate was given to there who had spontaneous menopause. Left ventricular systolic and diastolic function was evaluated by complete two-dimensional M-mode and pulsed Doppler echocardiography before and after 6 and 12 months of therapy. The parameters assessed were: systolic and diastolic blood pressure, heart rate, cardiac septal and posterior wall dimensions, left ventricular end-systolic and end-diastolic dimensions and volumes, ejection fraction (EF), ejection time, peak left ventricular outflow velocity (PFV), flow velocity integral (FVI), acceleration time (AT), mean acceleration of systolic flow (MA), duration of early and late filling phase, peak velocity of the early (E) and late (A) mitral flow, and A/E velocity ratio. Although no difference in chamber and wall dimensions between flushers and non-flushers was found, women with hot flushes had lower (not significantly) EF, PFV, FVI, MA, blood pressure and heart rate before therapy. Twelve-month estrogen replacement therapy significantly reduced cardiac wall dimensions and improved systolic function in both flushers and non-flushers. However, stroke volume, EF and MA were increased whereas systolic blood pressure and heart rate were decreased more in flushers. Also, the increase in E mitral flow and decrease in A/E were more pronounced in flushers. Thus, although estrogen replacement therapy significantly improves heart function in healthy postmenopausal women, there appears to be some minor differences in response between flushers and non-flushers.

Objective: Menopause and smoking have negative effects on the cardiovascular system. The study was planned to investigate the influence of oral hormone replacement therapy (HRT) on heart function and lipids in postmenopausal smokers. Methods: Lipid levels and left ventricular systolic and diastolic function by means of echocardiography were assessed before entering the study and at 6-month intervals during the 12 months of oral HRT in 62 postmenopausal women, 30 of whom were smokers and 32 were non-smokers. Results: Oral HRT caused a significant decrease in levels of total cholesterol and low density lipoprotein (LDL) cholesterol and a significant increase in high density lipoprotein (HDL) cholesterol in non-smokers. This effect was not evident in smokers. Echocardiography revealed a significant improvement of systolic function (ejection fraction, left ventricular outflow tract velocity, forward velocity integral, acceleration time and mean systolic acceleration) and diastolic function (diastolic time, duration of the early filling phase, peak velocity of early mitral flow, and the ratio of late to early peak mitral flow) in non-smokers. In smokers, a significant increase in some parameters of systolic function (ejection fraction, acceleration time and mean systolic acceleration) and an insignificant change in diastolic function were observed. Conclusion: Oral HRT of 12 months' duration has very limited beneficial effects on lipids and left ventricular heart function in postmenopausal women who smoke.

It has been suggested that some progestogens could have a stimulating effect on bone formation. This study was therefore undertaken in order to compare the influence of cyproterone acetate and norgestrel on bone metabolism when administered in a discontinuous, sequentially combined regimen with estradiol valerate. Twenty healthy early postmenopausal women were randomly assigned to treatment with either Cyclo-Progynova® containing 0.5 mg of norgestrel, or Climen® containing 1 mg of cyproterone acetate (CPA), over two 28-day cycles. Markers of bone resorption -fasting urinary hydroxypro-line / creatinine and calcium / creatinine ratios - and of bone formation - serum alkaline phosphatase and osteocalcin - were determined initially, before the start of treatment and thereafter twice weekly (a total of 17 assessments for each woman) during the 8-week treatment period. Serum osteocalcin concentrations were slightly but not significantly higher throughout the study period in women receiving Climen, compared to those taking Cyclo-Progynova. Cyclical fluctuation of serum osteocalcin levels were more pronounced in women with a high baseline level of osteocalcin. During the period of progestogen administration, osteocalcin concentrations were either similar to or even lower than those in the phase of administration of estradiol valerate alone. Serum calcium and alkaline phosphatase concentrations were relatively stable during the study period with both treatment regimens. Urinary excretion of calcium and hydroxyproline varied during the cycle but the variation was unrelated to either type or time of progestogen administration. Mean urinary hydroxyproline excretion during the 8-week study period was similar for both preparations, although the mean decrease in the urinary hydroxyproline /creatinine ratio was insignificantly higher for the CPA-containing preparation. Women with a high baseline osteocalcin level, however, showed significantly lower hydroxyproline excretion when treated with Climen than with a norgestrel-containing preparation. The significantly lower hydroxyproline excretion suggests a favorable effect on bone turnover of the preparation containing CPA. This effect was particularly obvious in women with a high bone turnover and was most probably the result of a potentiating effect of CPA on the anti-resorptive effect of estradiol valerate. © 1994 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted.

It has been suggested that some progestogens could have a stimulating effect on bone formation. This study was therefore undertaken in order to compare the influence of cyproterone acetate and norgestrel on bone metabolism when administered in a discontinuous, sequentially combined regimen with estradiol valerate. Twenty healthy early postmenopausal women were randomly assigned to treatment with either Cyclo-Progynova® containing 0.5 mg of norgestrel, or Climen® containing 1 mg of cyproterone acetate (CPA), over two 28-day cycles. Markers of bone resorption -fasting urinary hydroxypro-line / creatinine and calcium / creatinine ratios - and of bone formation - serum alkaline phosphatase and osteocalcin - were determined initially, before the start of treatment and thereafter twice weekly (a total of 17 assessments for each woman) during the 8-week treatment period. Serum osteocalcin concentrations were slightly but not significantly higher throughout the study period in women receiving Climen, compared to those taking Cyclo-Progynova. Cyclical fluctuation of serum osteocalcin levels were more pronounced in women with a high baseline level of osteocalcin. During the period of progestogen administration, osteocalcin concentrations were either similar to or even lower than those in the phase of administration of estradiol valerate alone. Serum calcium and alkaline phosphatase concentrations were relatively stable during the study period with both treatment regimens. Urinary excretion of calcium and hydroxyproline varied during the cycle but the variation was unrelated to either type or time of progestogen administration. Mean urinary hydroxyproline excretion during the 8-week study period was similar for both preparations, although the mean decrease in the urinary hydroxyproline /creatinine ratio was insignificantly higher for the CPA-containing preparation. Women with a high baseline osteocalcin level, however, showed significantly lower hydroxyproline excretion when treated with Climen than with a norgestrel-containing preparation. The significantly lower hydroxyproline excretion suggests a favorable effect on bone turnover of the preparation containing CPA. This effect was particularly obvious in women with a high bone turnover and was most probably the result of a potentiating effect of CPA on the anti-resorptive effect of estradiol valerate. © 1994 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted.