Schindler Thomas H, Campisi Roxana, Dorsey Deborah, Prior John O, Olschewski Manfred, Sayre James, Schelbert Heinrich R
Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, University of California at Los Angeles, 10833 Le Conte Ave, 23-120 CHS, Box 173517, Los Angeles, CA 90095-1735, USA.
Eur Heart J. 2009 Apr;30(8):978-86. doi: 10.1093/eurheartj/ehp013. Epub 2009 Feb 26.
The aim of this study was to evaluate the effect of hormone replacement therapy (HRT) on coronary vasomotor function in post-menopausal women (PM) with medically treated cardiovascular risk factors (RFs) in a cross-sectional and a longitudinal follow-up (FU) study.
Myocardial blood flow (MBF) response to cold pressor testing (CPT) and during pharmacologically induced hyperaemia was measured with positron emission tomography in pre-menopausal women (CON), in PM with HRT and without HRT, and repeated in PM after a mean FU of 24 +/- 14 months. When compared with CON at baseline, the endothelium-related change in MBF (DeltaMBF) to CPT progressively declined in PM with HRT and without HRT (0.35 +/- 0.23 vs. 0.24 +/- 0.20 and 0.16 +/- 0.12 mL/g/min; P = 0.171 and P = 0.021). In PM without HRT and in those with HRT at baseline but with discontinuation of HRT during FU, the endothelium-related DeltaMBF to CPT was significantly less at FU than at baseline (0.05 +/- 0.19 vs. 0.16 +/- 0.12 and -0.03 +/- 0.14 vs. 0.25 +/- 0.18 mL/g/min; P = 0.023 and P = 0.001), whereas no significant change was observed in PM with HRT (0.19 +/- 0.22 vs. 0.23 +/- 0.22 mL/g/min; P = 0.453). Impaired hyperaemic MBFs when compared with CON were not significantly altered from those at baseline exam.
Long-term administration of oestrogen may contribute to maintain endothelium-dependent coronary function in PM with medically treated cardiovascular RFs.
本研究旨在通过横断面研究和纵向随访研究，评估激素替代疗法（HRT）对患有经药物治疗的心血管危险因素（RFs）的绝经后女性（PM）冠状动脉血管舒缩功能的影响。
采用正电子发射断层扫描术，测量绝经前女性（CON）、接受HRT和未接受HRT的PM在冷加压试验（CPT）期间及药物诱导充血时的心肌血流量（MBF），并在平均随访24±14个月后，对PM进行重复测量。与基线时的CON相比，接受HRT和未接受HRT的PM中，CPT时MBF的内皮相关变化（ΔMBF）逐渐下降（0.35±0.23 vs. 0.24±0.20和0.16±0.12 mL/g/min；P = 0.171和P = 0.021）。在未接受HRT的PM以及基线时接受HRT但随访期间停用HRT的PM中，随访时CPT的内皮相关ΔMBF显著低于基线时（0.05±0.19 vs. 0.16±0.12和-0.03±0.14 vs. 0.25±0.18 mL/g/min；P = 0.023和P = 0.001），而接受HRT的PM未观察到显著变化（0.19±0.22 vs. 0.23±0.22 mL/g/min；P = 0.453）。与CON相比，充血MBF受损情况与基线检查时相比无显著变化。
长期给予雌激素可能有助于维持患有经药物治疗的心血管RFs的PM的内皮依赖性冠状动脉功能。
