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Abstract
Objective: Postmenopausal women with non-insulin dependent diabetes (NIDDM) are frequently
obese, hypertensive and hyperlipidaemic and hence at particular risk of coronary heart
disease (CHD). They might therefore benefit from menopausal therapy. In view of the
fact that oestrogen replacement increases cardiac flow but not limb flow whilst tibolone
dilates forearm flow in healthy postmenopausal women, a study was undertaken to evaluate
the effects of tibolone on cardiac flow in postmenopausal women with NIDDM. Design: A prospective 12 months before/after intervention study. Patients: 15 postmenopausal women (mean age 58.36 ± 1.25 years; mean duration of menopause
115.20 ± 13.97 months; mean BMI: 26.22 ± 1.02) with NIDDM (mean duration of diabetes
106.07 ± 15.66 months). Measurements: Cardiac flow was measured every 6 months for 1 year by pulsed Doppler echocardiography.
The parameters assessed were: stroke volume (SV), cardiac output (CO), ejection fraction
(EF), pre-ejection time (PEP), ejection time (ET), peak systolic flow velocity (PFV),
acceleration time (AT), flow velocity integral (FVI), mean acceleration (MA), early
diastolic filling time (Ei), atrial filling time interval (Ai), peak velocity of the
early diastolic filling (E) and peak velocity of the early atrial filling (A). Blood
pressure was also recorded during Doppler echocardiography. Results: Stroke volume, cardiac output and ejection fraction increased significantly after
6 months. There was also a significant increase in peak flow velocity (PFV), flow
velocity integral (FVI) and mean acceleration (MA) together with a significant increase
in early diastolic filling time (Ei) and peak velocity of the early diastolic filling
(E). Blood pressure was unchanged throughout the 12-month study period. Conclusion: The significant increase is stroke volume, cardiac output and flow velocity over
the aortic valve parallel the effects of oestrogens in healthy postmenopausal women.
The fact that tibolone improved left ventricular relaxation suggests the drug might
help prevent or at least defer the development of cardiac dysfunction in diabetic
women.
Keywords
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Article info
Publication history
Accepted:
January 17,
1997
Received in revised form:
January 9,
1997
Received:
September 23,
1996
Identification
Copyright
© 1997 Published by Elsevier Inc.
