Effects of oral and transdermal low-dose estrogen therapy on echocardiographic parameters of cardiac function

Objective: To investigate the effects of transdermal 17β-estradiol (E₂) compared with oral unopposed as well as opposed E₂ on echocardiographic parameters of left ventricular (LV) systolic and diastolic function. Design: A prospective, randomized, double-blind, placebo-controlled, multi-center study. Setting: Gynecologic and cardiologic outpatient departments. Patient(s): One hundred fifty-two healthy hysterectomized postmenopausal women. Intervention(s): Participants received daily placebo (n = 49) or transdermal E₂ (50 μg; tE₂ group, n = 33), or oral E₂ (1 mg; oE₂ group, n = 37), or oral E₂ (1 mg) combined with gestodene (25 μg; oE₂+G group, n = 33) for thirteen 28-day treatment cycles. Main Outcome Measure(s): M-mode, quantitative two-dimensional, and Doppler echocardiographic measurements were performed at baseline and after 1 year. Result(s): Compared with placebo, tE₂ and oE ₂ showed no statistically significant changes in LV function. oE ₂+G resulted in a statistically significant favorable increase in peak flow velocity, flow velocity integral, and mean acceleration. Furthermore, a favorable decrease was observed in interventricular septum thickness and ejection time. Conclusion(s): After 1 year of unopposed E₂, LV function remained unchanged. The oE₂+G treatment showed a potential beneficial influence on LV systolic function.