scholarly journals Effects of hormone replacement therapy on endothelial function, arterial stiffness and myocardial deformation in women with Turner syndrome

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
I Ikonomidis ◽  
G Pavlidis ◽  
I Mavroeidi ◽  
K Katogiannis ◽  
M Varoudi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Hormone Replacement Therapy ◽  
Arterial Stiffness ◽  
Endothelial Function ◽  
Replacement Therapy ◽  
Turner Syndrome ◽  
Hormone Replacement ◽  
Myocardial Deformation ◽  
Stiffness Index ◽  
Percent Decrease

Abstract Background/Introduction Turner syndrome (TS) is associated with increased cardiovascular risk. Purpose We investigated whether hormone replacement therapy (HRT) affects endothelial function, arterial stiffness and myocardial deformation in women with TS. Methods Twenty-five women with TS were studied in the estrogen phase of the HRT and two months after discontinuation of HRT. The following measurements were made: flow-mediated dilatation (FMD) of the brachial artery, pulse wave velocity (PWV-Complior) and central systolic blood pressure (cSBP), carotid intima-media thickness (cIMT), aortic (Ao) elastic indexes-namely Ao strain, distensibility, stiffness index and pressure strain modulus (Ep)-and left ventricular (LV) global longitudinal strain (GLS) using speckle tracking echocardiography. Ten healthy female of similar age and BMI served as control group. Results Compared to controls, women with TS on HRT had higher PWV (9.1±2.4 vs. 7.5±0.5m/s), cSBP (130±15 vs. 121±6mmHg), cIMT (0.66±0.06 vs. 0.55±0.05mm), aortic stiffness index, Ep and LA strain, and lower FMD (7.2±4 vs. 10.5±2.3%), Ao strain, Ao distensibility and GLS (−18.8±2.7 vs. −21.9±1.5%) (P<0.05 for all comparisons). Two months after discontinuation of HRT, all women increased FMD (11.7±6 vs. 7.2±4%) and reduced PWV (7.8±1.7 vs. 9.1±2.4m/s) and cSBP (123±14 vs. 130±15mmHg). There were no statistically significant changes in BMI, cIMT and GLS (P>0.05 for all comparisons). The percent decrease of cSBP was associated with the percent decrease of PWV (r=0.54) and reversely related with the percent increase of FMD (r=−0.57) (P<0.05 for all comparisons). Conclusion HRT in women with TS may deteriorate endothelial function contributing to increased arterial stiffness and central arterial blood pressure. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Effects of hormone replacement therapy on arterial stiffness, endothelial function and myocardial deformation in women with Turner syndrome

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
I Ikonomidis ◽  
G Pavlidis ◽  
I Mavroidi ◽  
M Varoudi ◽  
J Thymis ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Hormone Replacement Therapy ◽  
Arterial Stiffness ◽  
Endothelial Function ◽  
Replacement Therapy ◽  
Turner Syndrome ◽  
Pulse Wave ◽  
Hormone Replacement ◽  
Volume Index ◽  
Percent Decrease

Abstract Funding Acknowledgements Type of funding sources: None. Background/Introduction: Turner syndrome (TS) is associated with congenital or acquired cardiovascular diseases. Purpose We investigated whether hormone replacement therapy (HRT) affects arterial elastic properties, endothelial function and myocardial deformation in women with TS. Methods In 25 women with TS (age: 29 ± 9years) we measured  in the oestrogen phase of HRT cycle and 1 month after discontinuation of HRT: a)Pulse wave velocity (PWV-Complior), central systolic blood pressure (cSBP) and augmentation index (AI) of the aortic pulse wave, b)perfused boundary region (PBR) of the sublingual arterial microvessels, as a marker of endothelial glycocalyx thickness, c)carotid intima-media thickness (cIMT), d)flow-mediated dilatation (FMD) of the brachial artery and percentage difference of FMD (FMD%), and e)global LV longitudinal strain (GLS) and left atrium (LA) strain using speckle tracking echocardiography. Ten healthy subjects of similar sex, age and BMI served as control group. Results Compared to controls, women with TS under HRT had higher PWV (9.1 ± 2.4 vs. 7.5 ± 0.5m/s), AI (18 [7 to 27] vs. 5.8 [-10 to 19]%), cSBP (130 ± 15 vs. 121 ± 6mmHg), cIMT (0.66 ± 0.06 vs. 0.55 ± 0.05mm), FMD (7.2 ± 4 vs. 10 ± 2.3%) and lower LA volume index (14.3 ± 4 vs. 24 ± 13 mL/m²) and GLS (-18.8 ± 2.7 vs. -21.9 ± 1.5) (p < 0.05 for all comparisons). PBR was negatively related with FMD% (r=-0.58, p = 0.022) in women with TS under HRT. One month after discontinuation of HRT, all women reduced PWV, AI, cSBP and increased FMD. There were no statistically significant changes in BMI, PBR, cIMT, LA volume index, LA strain and LV GLS (p > 0.05 for all comparisons) (Table). The percent decrease of cSBP was associated with the percent decrease of PWV (r = 0.54) and inversely related with the percent increase of FMD (r=-0.57) (p < 0.05 for all comparisons). Conclusions Hormone replacement treatment in women with TS deteriorates arterial stiffness and endothelial function probably due to increased central arterial blood pressure. Women with Turner syndrome under HRT (n = 25) Women with Turner syndrome one month after discontinuation of HRT (n = 25) p-value PWV, m/s 9.1 ± 2.4 7.8 ± 1.7 0.028 Central SBP, mmHg 130 ± 15 123 ± 14 0.007 PBR, 5-25μm 2.11 ± 0.3 2.12 ± 0.2 0.983 cIMT, mm 0.66 ± 0.06 0.67 ± 0.06 0.947 FMD, % 7.2 ± 4 11.7 ± 6 0.042 LA strain, % 51 ± 12 54 ± 15 0.400 LV GLS, % -18.8 ± 2.7 -19.3 ± 2.3 0.594 Table

Effects of hormone replacement therapy on endothelial function, arterial stiffness and myocardial deformation in women with Turner syndrome

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Melpomeni Peppa ◽  
George Pavlidis ◽  
Ioanna Mavroeidi ◽  
Konstantinos Katogiannis ◽  
Maria Varoudi ◽  
...  
Keyword(s):  
Hormone Replacement Therapy ◽  
Arterial Stiffness ◽  
Endothelial Function ◽  
Replacement Therapy ◽  
Turner Syndrome ◽  
Hormone Replacement ◽  
Myocardial Deformation

Ambulatory Arterial Stiffness Index in Turner Syndrome: The Impact of Sex Hormone Replacement Therapy

2009 ◽  
Vol 72 (3) ◽  
pp. 184-189 ◽  
Author(s):  
Kristian H. Mortensen ◽  
Klavs W. Hansen ◽  
Mogens Erlandsen ◽  
Jens S. Christiansen ◽  
Claus H. Gravholt
Keyword(s):  
Hormone Replacement Therapy ◽  
Arterial Stiffness ◽  
Replacement Therapy ◽  
Turner Syndrome ◽  
Hormone Replacement ◽  
Sex Hormone ◽  
Stiffness Index ◽  
Arterial Stiffness Index ◽  
The Impact

Effects of hormone replacement therapy or raloxifene on ambulatory blood pressure and arterial stiffness in treated hypertensive postmenopausal women

2004 ◽  
Vol 94 (11) ◽  
pp. 1453-1456 ◽  
Author(s):  
L.ílian Soares da Costa ◽  
Monica Amorim de Oliveira ◽  
Valéria Siqueira Martins Rubim ◽  
Maurício Wajngarten ◽  
José Mendes Aldrighi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Hormone Replacement Therapy ◽  
Arterial Stiffness ◽  
Replacement Therapy ◽  
Postmenopausal Women ◽  
Ambulatory Blood Pressure ◽  
Hormone Replacement

Sex Hormone Replacement Therapy in Turner Syndrome: Impact on Morbidity and Mortality

2019 ◽  
Vol 105 (2) ◽  
pp. 468-478 ◽  
Author(s):  
Mette H Viuff ◽  
Agnethe Berglund ◽  
Svend Juul ◽  
Niels H Andersen ◽  
Kirstine Stochholm ◽  
...  
Keyword(s):  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Turner Syndrome ◽  
Hormone Replacement ◽  
Osteoporotic Fractures ◽  
Long Term Effects ◽  
Mortality And Morbidity ◽  
Central Registry ◽  
National Cohort ◽  
The Impact

Abstract Context The long-term effects of female hormone replacement therapy (HRT) in Turner syndrome (TS) are unknown. Objective To examine morbidity, mortality and medicinal use in TS and the impact of HRT in 45,X women. Design and Setting National cohort study, following all TS individuals ever diagnosed in Denmark from 1977 to 2014. Patients and Methods In the Danish Cytogenetic Central Registry, we identified 1156 females diagnosed with TS from 1960 to 2014, and, subsequently, Statistics Denmark randomly identified 115 577 age-matched female controls. TS women and their matched controls were linked with person-level data from the National Patient Registry and the Medication Statistics Registry, and they were compared concerning mortality, hospitalizations, and medical prescriptions. Among 329 45,X women, 44 had never been HRT treated, and 285 had been treated at some point. HRT treated women were compared with untreated concerning mortality, hospitalizations, and medical prescriptions. Results Endocrine and cardiovascular mortality and morbidity were significantly increased in TS compared with the matched controls. Comparing HRT treated with nontreated 45,X women, we found a similar mortality (hazard ratio 0.83, 95% confidence interval 0.38–1.79). Among the HRT-treated 45,X women, we found a significantly lower use of antihypertensives, antidiabetics, and thyroid hormones and significantly reduced hospitalization rates for stroke and osteoporotic fractures. Conclusion Women with TS have an increased overall mortality and morbidity. HRT seems to have a beneficial effect on endocrine conditions, hypertension, and stroke in women with 45,X karyotype, with no clear impact on mortality.

scholarly journals Quantitative liver functions in Turner syndrome with and without hormone replacement therapy

2007 ◽  
Vol 156 (6) ◽  
pp. 679-686 ◽  
Author(s):  
Claus Højbjerg Gravholt ◽  
Henrik Enghusen Poulsen ◽  
Peter Ott ◽  
Jens Sandahl Christiansen ◽  
Hendrik Vilstrup
Keyword(s):  
Hormone Replacement Therapy ◽  
Indocyanine Green ◽  
Replacement Therapy ◽  
Turner Syndrome ◽  
Liver Enzymes ◽  
Hormone Replacement ◽  
Amino Nitrogen ◽  
Excretory Function ◽  
Liver Functions ◽  
Galactose Elimination Capacity

Background: Studies have documented elevated levels of liver enzymes in many females with Turner syndrome (TS). Histology has shown a range of changes. Treatment with female hormone replacement therapy (HRT) reduces liver enzymes. Aim: To study quantitative liver functions in TS in detail with and without HRT. Design: Randomized crossover study with active treatment (HRT in TS and P-pill in controls) or no treatment. Subjects: Women with TS (n = 8, age 29.7 ± 5.6 (mean ± s.d.) years), verified by karyotype, and age-matched controls (C; n = 8, age 27.3 ± 4.9 years). Methods: We determined liver enzymes in blood, used the galactose elimination capacity to assess hepatocyte cytosol activity, plasma clearance of indocyanine green to assess excretory function, antipyrine clearance to estimate microsomal activity, and the functional hepatic nitrogen clearance (FHNC) to assess mitochondrial-cytosolic metabolic capacity for conversion of amino-nitrogen. Results: Liver enzymes were elevated in untreated TS and reduced by HRT. The hepatic capacities for conversion of galactose, indocyanine green, and antipyrine were normal and did not change by HRT. The FHNC was marginally reduced (untreated TS vs C: 19.4 ± 5.4 vs 25.2 ± 7.3 L/h, P = 0.1). FHNC changed slightly with HRT in TS (19.4 ± 5.4 vs 24.4 ± 10.2 L/h, P = 0.2). Conclusions: The elevations of liver enzymes in untreated TS are readily suppressed by HRT. Quantitative liver functions in TS are comparable to controls and are not affected by HRT.

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