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The effect of estrogen compared to estrogen plus progesterone on the exercise electrocardiogram

Bokhari, Sabahat ; Bergmann, Steven R

Journal of the American College of Cardiology, 2002-09, Vol.40 (6), p.1092-1096 [Periódico revisado por pares]

New York, NY: Elsevier Inc

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Título:
The effect of estrogen compared to estrogen plus progesterone on the exercise electrocardiogram
Autor: Bokhari, Sabahat ; Bergmann, Steven R
Assuntos: Age ; Aged ; Biological and medical sciences ; Blood pressure ; Cardiovascular disease ; Coronary Artery Disease - diagnosis ; Coronary Circulation - drug effects ; Diabetes ; Drug Therapy, Combination ; Electrocardiography - drug effects ; Electrocardiography. Vectocardiography ; Electrodiagnosis. Electric activity recording ; Estrogen Replacement Therapy ; Estrogens ; Estrogens, Conjugated (USP) - administration & dosage ; Estrogens, Conjugated (USP) - pharmacology ; Exercise Test - drug effects ; False Positive Reactions ; Family medical history ; Female ; Fitness equipment ; Heart rate ; Hormone replacement therapy ; Humans ; Hypertension ; Investigative techniques, diagnostic techniques (general aspects) ; Medical imaging ; Medical sciences ; Medroxyprogesterone - administration & dosage ; Medroxyprogesterone - pharmacology ; Menopause ; Middle Aged ; Patients ; Progesterone Congeners - administration & dosage ; Progesterone Congeners - pharmacology ; Retrospective Studies ; Sensitivity and Specificity ; Womens health
É parte de: Journal of the American College of Cardiology, 2002-09, Vol.40 (6), p.1092-1096
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Descrição: The objective of this study was to evaluate the effect of estrogen compared to estrogen plus progesterone on the stress electrocardiogram (ECG) in relationship to stress-gated myocardial perfusion imaging (MPI) in postmenopausal women. It is generally recognized that estrogen may cause false positive ST depressions on the stress ECG. The effects of estrogen plus progesterone are not known. This study was performed to define the effects of these agents on the stress ECG correlated with results from MPI. We evaluated 140 postmenopausal women—31 not taking any hormone replacement therapy (HRT); 75 taking estrogen alone; and 34 taking estrogen plus progesterone. Women with a history of coronary artery disease (CAD), cardiomyopathy, or an abnormal resting ECG were excluded. All women underwent a symptom-limited treadmill test and MPI. The overall sensitivity and specificity of the stress ECG compared to MPI in women not taking HRT was 54% and 78%, respectively. In women taking estrogen or estrogen plus progesterone, the sensitivity was unchanged. The power to detect clinically meaningful sensitivity difference (10%) was poor (p = 0.09). The specificity was reduced to 46% (p < 0.01) in women on estrogen therapy. In women taking estrogen plus progesterone, specificity was 80%. Our results suggest that estrogen increases the false positive rate of the stress ECG. This decreased specificity is countered by co-administration of progesterone. Nonetheless, because the sensitivity of the stress ECG is only 50% to 57% in postmenopausal women, women at risk should have imaging in conjunction with stress for the optimal detection of CAD.
Editor: New York, NY: Elsevier Inc
Idioma: Inglês

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The effect of estrogen compared to estrogen plus progesterone on the exercise electrocardiogram

Bokhari, Sabahat ; Bergmann, Steven R

New York, NY: Elsevier Inc

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