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P142 Diurnal variation in uterine artery pulsatility index in postmenopausal women using transdermal oestradiol
P142 (cant)
P142 DIURNAL VARIATION IN UTERINE ARTERY PULSATILITY INDEX IN POSTMENOPAUSAL WOMEN USING TRANSDERMAL OESTRADIOL D Ross, D Jurkovic,
VA Godfree. KE Morris, MI Whitehead
Menopause Clinic, King’sCollegeHospital,London,SE59RS,UK. Previous studies of pulsed doppler ultrasound have shown a significantdiurnal variation in uterine artery pulsatility index (PI reflectingimpedanceto blood flow) in premenopausal womenwith regularmenstrualcycles. We havemeasured the diurnalvariationin uterine artery PI in postmenopausal women using transdermal oestradiol. Twenty-two healthy postmenopausal womenwho had not had a hysterectomywere recruited, all of whom were using sequential combined HRT including transdermal oestradiol, 50 mcg/d. Cigarettesmokersand thosetaking drugsknown to affect arterial tone wereexcluded. Transvaginalpelvic ultrasoundwasperformed at 8 - 8.30 a.m.and6 - 6.30 p.m. on the sameday in the oestrogenonly phaseof therapy. Uterine artery PI measurements were made under standardisedconditions. Blood sampleswere taken for plasmaoestradioland cortisol concentrationsat the sametime as eachscan. Preliminaryanalysison 14 womenrevealeda significantincreasein mean(*SE) uterine artery PI betweenmorning(1.96 f 0.18) and evening(2.40 f 0.18) measurements (p < 0.05). PI resultsfor all womenwill be presented,alongwith the resultsof plasmaoestradiol andcortisolmeasurements.
The diurnal variation in uterine artery PI previously observedin premenopausal womenis also presentin postmenopausal women receivingconstantadministration of exogenous oestradiol.Although transdermal oestradiolhasbeenshownto affect uterineartery PI in postmenopausal women, it is clear that other factors are also operating. Clinical and researchuse of uterine artery PI in postmenopausal womenmusttake into accountthis diurnalvariation by performingrepeatedmeasurements at the sametime of day.
Continued
P143
P144
THE INFLUENCE OF HORMONAL REPLACEMENT THERAPY ON BLOOD FLOW.
EFFECTS OF CONTINUOUS COMBINED ESTROGEN AND PROGESTOGEN REPLACEMENT THERAPY ON THE UTERINE VASCULATUR TREE OF POSTMENOPAUSAL WOMEN
R Debski, M Binkowska, J Garwolinski, P Kretowicz,
MedicalCentreof Postgraduate Education,Departmentof Obstetrics MD&en, U Auf der Landwehr, HP G Schneider, andGynaecology,00-416Warsaw,Czemiakowska 231,Poland. University of Munster, Departmentof Obstetrics& Gynecology, Cardiovasculardiseaseis responsiblefor 50% of all femaledeaths. Albert-Schweitzer-St33, D-48129Mtinster,Germany. HRT reducesthe incidence of coronary heart diseasebut the Estrogen-induced vasodilatationis mediatedby nitric oxide, the comechanism is not fully known. UsingDopplerultrasoundto measureparameters of flow we have administrationof the nortestosteronederivative noretbisterone demonstrated that transdermal administrationof estradiol(Estraderm acetate(NETA) may attenuatethis effect. Thereforewe assessed 50) appearsto reducethe pulsatility index (PI) and the resistive blood flow - pulsatility and resistanceindices(RI, PI), peak and index (RI) in the common carotid and femoral artery in averagesystolicvelocities(PSV, ASV) - in the uterine,arcuate,and single-investigator studyby means hysterectomised womenafter 3, 6 and 12 monthsof therapy. The radialarteriesin a cross-sectional uterine, carotid and femoral artery PI and RI in postmenopausal of transvaginalcolor Doppler sonographyin late postmenopausal womenon the estrogenandprogestagen therapy(Cycle Progynova) womenwith hormonalreplacementtherapy(HRT; n=55) compared to controls(n=97) not different for postmenopausal interval (1I+6 werehigherbut still lowerthanin control groupwithout HRT. It seemsthat progestagenpartially reducethe beneficialaction of vs 8&8 years)and body massindex (25+3 vs 27+5) . All women estrogenon vascularresistivityof seventysix of ninety healthy,early werenormotensiveand without evidenceof cardiovasculardisease. HRT, intendedto maintainamenorrhea, consistedof 2mgestradiol+ postmenopausal womencompletedthe oneyear study. lmg estriol+ lmg NETA daily for a meandurationof 4&3 years. We foundthat PI (pc.02) andRI (pc.002) of the uterinearteries,PI (pc.008) and PSV (pcO.02) of the radial arteries,were reduced significantly comparedto controls. ASV was most profoundly increased in both uterineandradialarteries(p<.OOO2). Blood flow in the arcuatearteries(RI, PI) tendedto be reduced,too (P=O.O8).In conclusion,chronicdaily useof oral estradiol2mgand estriol lmg combinedwith NETA lmg is associated with an increaseof arterial flow in the uterinearteriesand the mostperipheralradial arteries, thuspointingtowardsa sustained improvementof perfusion.
161
P142 DIURNAL VARIATION IN UTERINE ARTERY PULSATILITY INDEX IN POSTMENOPAUSAL WOMEN USING TRANSDERMAL OESTRADIOL D Ross, D Jurkovic,
VA Godfree. KE Morris, MI Whitehead
Menopause Clinic, King’sCollegeHospital,London,SE59RS,UK. Previous studies of pulsed doppler ultrasound have shown a significantdiurnal variation in uterine artery pulsatility index (PI reflectingimpedanceto blood flow) in premenopausal womenwith regularmenstrualcycles. We havemeasured the diurnalvariationin uterine artery PI in postmenopausal women using transdermal oestradiol. Twenty-two healthy postmenopausal womenwho had not had a hysterectomywere recruited, all of whom were using sequential combined HRT including transdermal oestradiol, 50 mcg/d. Cigarettesmokersand thosetaking drugsknown to affect arterial tone wereexcluded. Transvaginalpelvic ultrasoundwasperformed at 8 - 8.30 a.m.and6 - 6.30 p.m. on the sameday in the oestrogenonly phaseof therapy. Uterine artery PI measurements were made under standardisedconditions. Blood sampleswere taken for plasmaoestradioland cortisol concentrationsat the sametime as eachscan. Preliminaryanalysison 14 womenrevealeda significantincreasein mean(*SE) uterine artery PI betweenmorning(1.96 f 0.18) and evening(2.40 f 0.18) measurements (p < 0.05). PI resultsfor all womenwill be presented,alongwith the resultsof plasmaoestradiol andcortisolmeasurements.
The diurnal variation in uterine artery PI previously observedin premenopausal womenis also presentin postmenopausal women receivingconstantadministration of exogenous oestradiol.Although transdermal oestradiolhasbeenshownto affect uterineartery PI in postmenopausal women, it is clear that other factors are also operating. Clinical and researchuse of uterine artery PI in postmenopausal womenmusttake into accountthis diurnalvariation by performingrepeatedmeasurements at the sametime of day.
Continued
P143
P144
THE INFLUENCE OF HORMONAL REPLACEMENT THERAPY ON BLOOD FLOW.
EFFECTS OF CONTINUOUS COMBINED ESTROGEN AND PROGESTOGEN REPLACEMENT THERAPY ON THE UTERINE VASCULATUR TREE OF POSTMENOPAUSAL WOMEN
R Debski, M Binkowska, J Garwolinski, P Kretowicz,
MedicalCentreof Postgraduate Education,Departmentof Obstetrics MD&en, U Auf der Landwehr, HP G Schneider, andGynaecology,00-416Warsaw,Czemiakowska 231,Poland. University of Munster, Departmentof Obstetrics& Gynecology, Cardiovasculardiseaseis responsiblefor 50% of all femaledeaths. Albert-Schweitzer-St33, D-48129Mtinster,Germany. HRT reducesthe incidence of coronary heart diseasebut the Estrogen-induced vasodilatationis mediatedby nitric oxide, the comechanism is not fully known. UsingDopplerultrasoundto measureparameters of flow we have administrationof the nortestosteronederivative noretbisterone demonstrated that transdermal administrationof estradiol(Estraderm acetate(NETA) may attenuatethis effect. Thereforewe assessed 50) appearsto reducethe pulsatility index (PI) and the resistive blood flow - pulsatility and resistanceindices(RI, PI), peak and index (RI) in the common carotid and femoral artery in averagesystolicvelocities(PSV, ASV) - in the uterine,arcuate,and single-investigator studyby means hysterectomised womenafter 3, 6 and 12 monthsof therapy. The radialarteriesin a cross-sectional uterine, carotid and femoral artery PI and RI in postmenopausal of transvaginalcolor Doppler sonographyin late postmenopausal womenon the estrogenandprogestagen therapy(Cycle Progynova) womenwith hormonalreplacementtherapy(HRT; n=55) compared to controls(n=97) not different for postmenopausal interval (1I+6 werehigherbut still lowerthanin control groupwithout HRT. It seemsthat progestagenpartially reducethe beneficialaction of vs 8&8 years)and body massindex (25+3 vs 27+5) . All women estrogenon vascularresistivityof seventysix of ninety healthy,early werenormotensiveand without evidenceof cardiovasculardisease. HRT, intendedto maintainamenorrhea, consistedof 2mgestradiol+ postmenopausal womencompletedthe oneyear study. lmg estriol+ lmg NETA daily for a meandurationof 4&3 years. We foundthat PI (pc.02) andRI (pc.002) of the uterinearteries,PI (pc.008) and PSV (pcO.02) of the radial arteries,were reduced significantly comparedto controls. ASV was most profoundly increased in both uterineandradialarteries(p<.OOO2). Blood flow in the arcuatearteries(RI, PI) tendedto be reduced,too (P=O.O8).In conclusion,chronicdaily useof oral estradiol2mgand estriol lmg combinedwith NETA lmg is associated with an increaseof arterial flow in the uterinearteriesand the mostperipheralradial arteries, thuspointingtowardsa sustained improvementof perfusion.
161