scholarly journals Evidence That Parenteral Testosterone Therapy May Improve Endothelium-Dependent and -Independent Vasodilation in Postmenopausal Women Already Receiving Estrogen

2001 ◽  
Vol 86 (1) ◽  
pp. 158-161 ◽  
Author(s):  
Samantha Worboys ◽  
Dimitra Kotsopoulos ◽  
Helena Teede ◽  
Barry McGrath ◽  
Susan R. Davis
Keyword(s):  
Postmenopausal Women ◽  
Brachial Artery ◽  
Repeated Measures ◽  
Reactive Hyperemia ◽  
Hormone Replacement ◽  
Estrogen Therapy ◽  
Control Group ◽  
Testosterone Therapy ◽  
Brachial Artery Diameter ◽  
Dependent Flow

The gender difference in cardiovascular disease has been partly attributed to higher androgenic hormone levels. Although testosterone in women may not affect lipids, it remains unknown whether it negates favorable estrogenic effects on endothelial function. We have investigated the effects of testosterone implant therapy on arterial reactivity encompassing endothelial-dependent and -independent vasodilation in women using hormone replacement therapy (HRT). B-mode ultrasound measurements of resting brachial artery diameter, following reactive hyperemia [endothelium-dependent flow- mediated dilation (FMD)] and following glyceryl trinitrate (GTN) (endothelium-independent dilation), were recorded in 33 postmenopausal women stabilized on HRT (>6 months), at baseline, and 6 weeks after a testosterone implant (50 mg), with 15 postmenopausal nonusers of HRT serving as controls. In the brachial artery, baseline resting diameter was similar (0.40 ± 0.01 vs. 0.41 ± 0.01 cm, P = 0.5). In the treated group, testosterone levels increased (0.99 ± 0.08 to 4.99 ± 0.3 nmol/L, P < 0.001), associated with a mean 42% increase in FMD (6.4% ± 0.7 to 9.1% ± 1.1, P = 0.03). The control group did not change (8.1% ± 1.4 to 5.6% ± 1.0, P = 0.4). ANOVA of repeated measures (P = 0.04) and mean change (P = 0.02) in FMD both demonstrated significantly greater improvement with testosterone compared with controls. GTN induced vasodilation increased with testosterone treatment (14.9% ± 0.9 to 17.8% ± 1.2, P = 0.03). Our preliminary data indicate that parenteral testosterone therapy improves both endothelial-dependent (flow-mediated) and endothelium-independent (GTN-mediated) brachial artery vasodilation in postmenopausal women using long-term estrogen therapy. The mechanisms underlying these potentially beneficial cardiovascular effects require further investigation.

Normal pregnancy is associated with enhanced endothelium-dependent flow-mediated vasodilation

1999 ◽  
Vol 276 (3) ◽  
pp. H821-H825 ◽  
Author(s):  
Inge Dørup ◽  
Kristjar Skajaa ◽  
Keld E. Sørensen
Keyword(s):  
Brachial Artery ◽  
Reactive Hyperemia ◽  
Peripheral Resistance ◽  
First Trimester ◽  
Normal Pregnancy ◽  
Brachial Artery Diameter ◽  
Vasomotor Function ◽  
Pregnancy Status ◽  
Dependent Flow ◽  
Flow Mediated Vasodilation

Normal pregnancy is characterized by reduced systemic vascular resistance, which may be mediated by nitric oxide (NO). We compared endothelial vasomotor function in 71 normal pregnant women (13 in first, 29 in middle, and 29 in last trimester) to 37 healthy age-matched controls. With external ultrasound, brachial artery diameter was measured at rest, during reactive hyperemia [with increased flow causing endothelium-dependent dilation (FMD)], and after sublingual nitroglycerin (causing endothelium-independent dilation). Compared with controls, resting flow and brachial artery diameter were significantly higher during the middle and last trimesters. Reactive hyperemia was reduced in all pregnant groups. FMD increased from the first trimester (by 26%), reaching the highest value in the last trimester (to 47% above nonpregnant values). FMD was significantly correlated to pregnancy status (nonpregnant or pregnant) and to vessel size. Nitroglycerin-induced dilation was similar in pregnant and nonpregnant women. A longitudinal study of eight women evaluated in the first, middle, and last trimesters confirmed an increase in FMD throughout pregnancy. The study supports the idea that basal and stimulated NO activity is enhanced in normal pregnancy and may contribute to the decrease in peripheral resistance.

Abstract 12000: Altered Vascular Elasticity Reflected Vascular Endothelial Dysfunction and Elevated Galectin-3 Using Novel Brachial Artery Vascular Volume Elastic Modulus With Automated Oscillometric Approach

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Keiichiro Yoshinaga ◽  
Yuuki Tomiyama ◽  
Satoshi Fujii ◽  
Saori Nishio ◽  
Noriki Ochi ◽  
...  
Keyword(s):  
Elastic Modulus ◽  
Brachial Artery ◽  
Vascular Function ◽  
Inflammatory Marker ◽  
Reactive Hyperemia ◽  
Vascular Stiffness ◽  
Brachial Artery Diameter ◽  
Novel Approach ◽  
Galectin 3 ◽  
Vascular Elasticity

Introduction: Simple vascular function measurements are desirable for atherosclerosis risk assessments. Recently, we developed a novel modality of automated oscillometric method to measure a brachial artery’s vascular elastic modulus (V E ) and reported that V E is uninfluenced by blood pressure. Galectin-3 (Gal-3) expressed in endothelial cells regulates vascular fibrosis and is a molecular determinant of vascular stiffness. Hypothesis: We aimed to clarify whether V E selectively correlates with marker of vascular stiffness in chronic kidney disease (CKD). Methods: 12 moderate-to-severe CKD pts (mean eGFR 25.9±23.5 mL/min/1.73m 2 ) and 15 controls were studied. Rest V E in brachial artery was measured by new automated oscillometric detector. V E was defined as follows [VE =ΔPressure/ (100XΔarea/Area) mmHg/%]. Using ultrasound, the brachial artery diameter at rest and during reactive hyperemia [flow mediated dilatation (FMD) with endothelial-dependent dilatation] was measured. Gal-3 and interleukin-6 (IL-6), a representative inflammatory marker, were measured by enzyme-linked immune assay. Results: CKD had lower FMD (4.86±3.37 vs 9.05±2.98 %, P=0.003) and had attenuated V E than control (1.08±0.26 vs 0.83±0.17 mmHg/%, P=0.002). CKD had higher IL-6 (0.67±0.29 vs 0.29±0.33 pg/mL, P=0.003) and higher Gal-3 (20.0±12.4 vs. 5.84±2.83 pg/mL, P<0.001). V E was negatively correlated with %FMD (r=-0.46, P=0.015) and correlated with Gal-3 (r=0.40, P=0.036) but not in IL-6 (r=0.21, P=0.28). Conclusions: Attenuated vascular elasticity detected by this novel approach closely correlated with increase in Gal-3 and reduced FMD in CKD. This may indicate that the attenuated vascular elasticity selectively reflects vascular fibrosis as evidenced by Gal-3 and subsequent endothelial responses to vascular stiffness. Thus, this oscillometric measurement may be useful for detecting vascular fibrosis information and dysfunction in endothelium level.

Effect of Hormone Replacement Therapy on Ocular Hemodynamics in Postmenopausal Women

2001 ◽  
Vol 11 (3) ◽  
pp. 277-280 ◽  
Author(s):  
H. Atílla ◽  
A. Arslanpençe ◽  
F. Batioğlu ◽  
T. Eryilmaz ◽  
S. Aytaç ◽  
...  
Keyword(s):  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Postmenopausal Women ◽  
Doppler Ultrasonography ◽  
Hormone Replacement ◽  
Control Group ◽  
Medication History ◽  
The Mean ◽  
Ocular Hemodynamics ◽  
Flow Velocities

Purpose To evaluate the effect of hormone replacement therapy on ocular hemodynamics in postmenopausal women. Methods Ocular Doppler ultrasonography was performed in 20 postmenopausal women on hormone replacement therapy (HRT) and in 20 women without treatment, as the control group. Central retinal artery (CRA), posterior ciliary artery (PCA) and ophthalmic artery (OA) flow velocities and vascular resistances were measured prospectively by a radiologist blinded to the therapy. There were no associated systemic or ocular diseases or any medication history. Results The mean age of the patients on HRT was 50.05 ± 4.5 yrs (range 44 - 62). The mean age of the control group was 52.8 ± 4.09 yrs (range 46 - 65). The mean duration of HRT was 1.6 ± 1.4 yrs (range 3 months - 5 years). There were no differences between the groups in terms of flow velocities, vascular resistivities or pulsatility indices of OA, CRA and PCA (p>0.05). Conclusions HRT is essential in postmenopausal women for relief of vasomotor symptoms, cardioprotection and prevention of osteoporosis. Even though vaso-occlusive complications of hormone preparations have been reported, we did not observe any changes in ocular hemodynamics detectable with Doppler ultrasonography.

scholarly journals Noninvasive Assessment of Endothelium-Dependent Flow-Mediated Dilation of the Brachial Artery

1997 ◽  
Vol 2 (2) ◽  
pp. 87-92 ◽  
Author(s):  
Akimi Uehata ◽  
Eric H Lieberman ◽  
Marie D Gerhard ◽  
Todd J Anderson ◽  
Peter Ganz ◽  
...  
Keyword(s):  
Blood Flow ◽  
Endothelial Function ◽  
Brachial Artery ◽  
Vascular Function ◽  
Reactive Hyperemia ◽  
Intraobserver Variability ◽  
Flow Mediated Dilation ◽  
Noninvasive Technique ◽  
Brachial Artery Diameter ◽  
Cuff Occlusion

Coronary atherosclerosis is characterized by an early loss of endothelium-dependent vasodilation. However, the methods of assessing coronary endothelial function are invasive and difficult to repeat over time. Recently, a noninvasive ultrasound method has been widely used to measure flow-mediated dilation in the brachial artery as a surrogate test for endothelial function. We seek to further validate this method of measuring vascular function. The brachial artery diameters and blood flow of 20 normal volunteers (10 males and 10 females) were measured using high resolution (7.5 MHz) ultrasound and strain gauge plethysmography. Flow-mediated endothelium-dependent vasodilation was measured in the brachial artery during reactive hyperemia after 5 minutes of cuff occlusion in the upper arm. The brachial artery diameter increased maximally by 9.7 ± 4.3% from baseline at 1 min after cuff release and blood flow increased by 1002 ± 376%. Five min of cuff occlusion was sufficient to achieve 97 ± 6% of maximal brachial artery dilation and degree of dilation was not different whether the cuff was inflated proximally or distally to the image site. The intraobserver variability in measuring brachial diameters was 2.9 % and the variability of the hyperemic response was 1.4%. In young, healthy men and women, the baseline brachial artery diameter was the only factor that was predictive of the flow-mediated vasodilation response. The brachial noninvasive technique has been further validated by the determination of flow-mediated dilation. This method of assessing endothelial function may help to determine the importance of vasodilator dysfunction as a risk factor in the development of atherosclerosis.

Impact of controlling shear rate on flow-mediated dilation responses in the brachial artery of humans

2004 ◽  
Vol 97 (2) ◽  
pp. 499-508 ◽  
Author(s):  
Kyra E. Pyke ◽  
Erin M. Dwyer ◽  
Michael E. Tschakovsky
Keyword(s):  
Shear Stress ◽  
Shear Rate ◽  
Brachial Artery ◽  
Reactive Hyperemia ◽  
Flow Mediated Dilation ◽  
Response Peak ◽  
Dependent Flow ◽  
Flow Mediated Vasodilation ◽  
The Impact ◽  
Forearm Occlusion

The reactive hyperemia test (RHtest) evokes a transient increase in shear stress as a stimulus for endothelial-dependent flow-mediated vasodilation (EDFMD). We developed a noninvasive method to create controlled elevations in brachial artery (BA) shear rate (SR, estimate of shear stress), controlled hyperemia test (CHtest), and assessed the impact of this vs. the RHtest approach on EDFMD. Eight healthy subjects participated in two trials of each test on 3 separate days. For the CHtest, SR was step increased from 8 to 50 s−1, created by controlled release of BA compression during forearm heating. For the RHtest, transient increases in SR were achieved after 5 min of forearm occlusion. BA diameter and blood flow velocity (ultrasound) were measured upstream of compression and occlusion sites. Both tests elicited significant dilation (RHtest: 6.33 ± 3.12%; CHtest: 3.00 ± 1.05%). The CHtest resulted in 1) reduced between-subject SR and EDFMD variability vs. the RHtest [SR coefficient of variation (CV): 4.9% vs. 36.6%; EDFMD CV: 36.16% vs. 51.80%] and 2) virtual elimination of the impact of BA diameter on the peak EDFMD response (peak EDFMD vs. baseline diameter for RHtest, r2 = 0.64, P < 0.01, vs. CHtest, r2 = 0.14, P < 0.01). Normalization of the RHtest EDFMD response to the magnitude of the SR stimulus eliminated test differences in between-subject response variability. Reductions in trial-to-trial and day-to-day SR variability with the CHtest did not reduce EDFMD variability. Between-subject SR variability contributes to EDFMD variability with the RHtest. SR controls with the CHtest or RHtest response normalization are essential for examining EDFMD between groups differing in baseline arterial diameter.

scholarly journals Hormone replacement therapy affects body composition and leptin differently in obese and non-obese postmenopausal women

1999 ◽  
Vol 163 (1) ◽  
pp. 55-62 ◽  
Author(s):  
K Kristensen ◽  
SB Pedersen ◽  
P Vestergaard ◽  
L Mosekilde ◽  
B Richelsen
Keyword(s):  
Body Composition ◽  
Adipose Tissue ◽  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Postmenopausal Women ◽  
Body Fat ◽  
Fat Mass ◽  
Hormone Replacement ◽  
Control Group ◽  
Obese Subjects

Leptin and oestrogen are both involved in the regulation of adipose tissue deposition and feeding behaviour. We investigated whether 5 years of hormone replacement therapy (HRT) affected serum leptin and body composition differently in 89 postmenopausal women treated with HRT compared with 178 controls. At baseline, leptin was significantly correlated with oestradiol (r=0.13, P<0.05) and in multiple backward regression analysis including oestradiol and any estimate of body fat, oestradiol remained a significant determinant of leptin levels. In the control group, all estimates of body fat determined by dual energy X-ray absorptiometry (DEXA) or anthropometry were increased (3.6-16.9%) and leptin increased 31.3% (16.03+/-1.02 to 20.84+/-1.2 ng/ml (s.e.m.), P<0.001). In the HRT group all estimates of body composition also increased during the 5-year observation but to a lesser extent than observed in the control group (1.0-8.5%). Leptin was raised by 19.7% (17.81+/-1.32 to 20.57+/-1.65 ng/ml, P<0.001). However, the DEXA scans revealed that the control group gained 2.4-fold more fat during the 5-year observation (1.9+/-0.3 vs 0.8+/-0.4 kg, P<0.05), and especially the trunk fat increased (1.4+/-0.2 vs 0.7+/-0.3 kg, P<0.05). This was reflected in the increase in leptin levels, which were increased by 7.4% in the control group compared with the HRT group (4.81+/-0.60 vs 2.76+/-0.87 ng/ml, P<0.05). Adjusting for the difference in adipose tissue revealed that HRT had no independent effect on leptin levels. Comparisons between obese (body mass index>25 kg/m(2)) and non-obese (<25 kg/m(2)) subjects by stratifying for HRT treatment using multiple linear regression revealed that the change in fat mass was significantly less among treated subjects (P=0.038) and especially in the non-obese subjects (P=0.001). The change in trunk fat was similarly correlated with treatment status (P=0.029) and with the degree of obesity (P=0.006). In conclusion, 5 years of HRT treatment significantly reduced fat mass accumulation, especially in the trunk region. This effect of HRT was more pronounced in non-obese as compared with obese subjects. The HRT-induced reduction in fat mass seems not to be mediated by leptin.

scholarly journals Influence of hormone replacement therapy on eccentric exercise induced myogenic gene expression in postmenopausal women

2009 ◽  
Vol 107 (5) ◽  
pp. 1381-1388 ◽  
Author(s):  
Christina M. Dieli-Conwright ◽  
Tanya M. Spektor ◽  
Judd C. Rice ◽  
Fred R. Sattler ◽  
E. Todd Schroeder
Keyword(s):  
Gene Expression ◽  
Hormone Replacement Therapy ◽  
Mrna Expression ◽  
Replacement Therapy ◽  
Postmenopausal Women ◽  
Eccentric Exercise ◽  
Hormone Replacement ◽  
Control Group ◽  
Regulatory Factor ◽  
Myogenic Regulatory Factor

Hormone replacement therapy (HRT) is used in postmenopausal women to relieve symptoms of menopause and prevent osteoporosis. We sought to evaluate changes in mRNA expression of key myogenic factors in postmenopausal women taking and not taking HRT following a high-intensity eccentric resistance exercise. Fourteen postmenopausal women were studied and included 6 control women not using HRT (59 ± 4 years, 63 ± 17 kg) and 8 women using traditional HRT (59 ± 4 yr, 89 ± 24 kg). Both groups performed 10 sets of 10 maximal eccentric repetitions of single-leg extension on a Cybex dynamometer at 60°/s. Muscle biopsies of the vastus lateralis were obtained from the exercised leg at baseline and 4 h after the exercise bout. Gene expression was determined using RT-PCR for follistatin, forkhead box 3A (FOXO3A), muscle atrophy F-box (MAFbx), muscle ring finger-1 (MuRF-1), myogenic differentiation factor (MyoD), myogenin, myostatin, myogenic factor 5 (Myf5), and muscle regulatory factor 4 (MRF4). At rest, the HRT group expressed higher levels of MyoD, myogenin, Myf5, MRF4, and follistatin ( P < 0.05). In response to eccentric exercise, follistatin, MyoD, myogenin, Myf5, and MRF4 were significantly increased ( P ≤ 0.05) and FOXO3A, MAFbx, MuRF-1, and myostatin were significantly decreased in the control and HRT groups ( P ≤ 0.05). Significantly greater changes in mRNA expression of follistatin, FOXO3A, MAFbx, MuRF-1, MyoD, myogenin, myostatin, Myf5, and MRF4 (p≤0.05) occurred in the HRT group than in the control group after exercise. These data suggest that postmenopausal women using HRT express higher myogenic regulatory factor gene expression, which may reflect an attempt to preserve muscle mass. Furthermore, postmenopausal women using HRT experienced a greater myogenic response to maximal eccentric exercise.

scholarly journals Impaired handgrip exercise-induced brachial artery flow-mediated dilation in young obese males

2016 ◽  
Vol 41 (5) ◽  
pp. 528-537 ◽  
Author(s):  
David J. Slattery ◽  
Troy J.R. Stuckless ◽  
Trevor J. King ◽  
Kyra E. Pyke
Keyword(s):  
Shear Stress ◽  
Brachial Artery ◽  
Reactive Hyperemia ◽  
Obese Group ◽  
Stress Profile ◽  
Flow Mediated Dilation ◽  
Handgrip Exercise ◽  
Brachial Artery Diameter ◽  
Shear Stress Profile ◽  
Forearm Occlusion

Flow mediated dilation (FMD) stimulated by different shear stress stimulus profiles may recruit distinct transduction mechanisms, and provide distinct information regarding endothelial function. The purpose of this study was to determine whether obesity influences brachial artery FMD differently depending on the shear stress profile used for FMD assessment. The FMD response to a brief, intermediate, and sustained shear stress profile was assessed in obese (n = 9) and lean (n = 19) young men as follows: brief stimulus, standard reactive hyperemia (RH) following a 5 min forearm occlusion (5 min RH); intermediate stimulus, RH following a 15 min forearm occlusion (15 min RH); sustained stimulus, 10 min of handgrip exercise (HGEX). Brachial artery diameter and mean shear stress were assessed using echo and Doppler ultrasound, respectively, during each FMD test. There was no group difference in HGEX shear stress (p = 0.390); however, the obese group had a lower HGEX-FMD (5.2 ± 3.0% versus 11.5 ± 4.4%, p < 0.001). There was no group difference in 5 min RH-FMD (p = 0.466) or 15 min RH-FMD (p = 0.181); however, the shear stress stimulus was larger in the obese group. After normalization to the stimulus the 15 min RH-FMD (p = 0.002), but not the 5 min RH-FMD (p = 0.118) was lower in the obese group. These data suggest that obesity may have a more pronounced impact on the endothelium’s ability to respond to prolonged increases in shear stress.

scholarly journals Role of hormone replacement therapy in relieving oral dryness symptoms in postmenopausal women: a case control study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lina Wang ◽  
Lilei Zhu ◽  
Yao Yao ◽  
Yajuan Ren ◽  
Hongcan Zhang
Keyword(s):  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Postmenopausal Women ◽  
Hormone Replacement ◽  
Dry Mouth ◽  
Control Group ◽  
Case Group ◽  
Oral Dryness ◽  
Estradiol Levels ◽  
Control Study

Abstract Background To evaluate the efficacy of hormone replacement therapy in relieving oral symptoms in postmenopausal women presenting with genitourinary symptoms along with oral dryness. Methods A case–control study was conducted after selecting 60 postmenopausal women. Oral dryness status of all the patients was evaluated with the help of questionnaire related to oral dryness. These subjects were divided into case group and control group on the basis of response to questionnaire of oral dryness. Unstimulated saliva samples were obtained and analyzed for estimation of salivary estradiol levels by enzyme linked immune sorbent assay technique. After analyzing the result of salivary estradiol levels, case group was subjected to hormone replacement therapy (HRT). The patients were followed up for their response towards oral dryness as well as salivary estradiol levels after the therapy. Results The mean salivary estradiol level before HRT was significantly more among control group as compared to case group (p value < 0.001). Most of the patients complained of dry mouth (26 out of 30); reduced amount of saliva in the mouth (25 out of 30); dry mouth at night (28 out of 30); dry mouth during the day (25 out of 30) before HRT. These complains were significantly reduced after the therapy. The mean salivary estradiol in the case group levels increased significantly after HRT (p value < 0.001). Conclusion The salivary estradiol levels were reduced in post menopausal women with the complain of xerostomia as compared to those without the complain of xerostomia. Further these levels can be recovered with the help of hormone replacement therapy.

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