The effect of oestrogen and progestogen replacement therapy on systolic flow velocity in healthy postmenopausal women.

The effects on left ventricular systolic outflow velocity of 3 months' treatment with either continuous transdermal oestradiol or cyclical transdermal oestradiol with medroxyprogesterone acetate were assessed in 34 healthy postmenopausal women. Cardiac flow was measured by pulsed wave Doppler echocardiography in 14 of these women and by continuous wave Doppler echocardiography in 20. Control studies were made in ten premenopausal women using pulse wave Doppler and in ten with continuous wave Doppler. The indicators assessed were: ejection fraction (EF), preejection time (PEP), ejection time (ET), peak systolic flow velocity over the aortic valve (PFV), acceleration time (AT), flow velocity integral (FVI) and mean acceleration (MA). Postmenopausal women had significantly lower EF, PFV, FVI, MA but longer AT and ET compared to premenopausal women. After 3 months' transdermal oestradiol significant increases in EF, PFV, FVI and MA were observed whilst AT decreased. The response in all cardiac flow indicators was similar with added progestogen. Blood pressure, however, increased after the addition of progestogen. Nevertheless the addition of progestogen does not attenuate the effect of oestrogen therapy on left ventricular systolic flow velocity.