Key result
The late follicular phase of the menstrual cycle, characterized by high estradiol levels, preserved flow-mediated dilatation after ischemia-reperfusion injury compared to the early follicular phase (7.0% vs 3.6%, p=0.03).
Why the study?
Does the late follicular phase (high estradiol) prevent ischemia-reperfusion-induced endothelial dysfunction compared to the early follicular phase in healthy premenopausal women?
Observational (n=10)
Investigator-blind
Not randomized
No
Does the late follicular phase (high estradiol) prevent ischemia-reperfusion-induced endothelial dysfunction compared to the early follicular phase in healthy premenopausal women?
Absolute Event Rate: 7% vs 3.6%
p-value: p=0.03
The surge in estradiol during the late follicular phase of the menstrual cycle attenuates endothelial dysfunction associated with ischemia-reperfusion injury in healthy premenopausal women.
High estradiol may attenuate ischemia-reperfusion endothelial dysfunction in premenopausal women; hypothesis-generating before clinical translation.
In premenopausal women, ovarian steroids are felt to play a role in the prevention of cardiovascular disease. We aimed to assess whether menstrual cycle variations in estrogen can modify the response to ischemia–reperfusion (IR) injury in humans. In an investigator-blinded crossover study, 10 healthy premenopausal women with regular menstrual cycles were studied. They had flow-mediated dilatation (FMD) measured by ultrasound in the radial artery before and after IR (15 min of brachial artery ischemia, 15 min of reperfusion) during both the early and late follicular phases of the menstrual cycle. The order of these visits was not randomized. IR significantly blunted FMD in the early follicular phase (pre-IR: 7.1% ± 1.0%; post-IR: 3.6% ± 1.0%, P = 0.01) when estradiol levels were low (148.4 ± 19.8 pmol/L). Conversely, FMD was preserved after IR during the late follicular phase (pre-IR: 7.2% ± 0.9%; post-IR: 7.0% ± 0.8%, P = NS, P = 0.03 compared with early follicular) when estradiol levels were high (825.7 ± 85.8 pmol/L, P < 0.001 compared with early follicular). There was a significant inverse relationship between estradiol concentration and IR-induced endothelial dysfunction (i.e., change in FMD after IR) (r = 0.59, r 2 = 0.36, P < 0.01). These findings demonstrate, for the first time in humans, a clear relationship between the cyclical changes in serum concentrations of estradiol and the endothelium’s response to IR.
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Luca et al. (2016) conducted an observational in Healthy (n=10). Late follicular phase (high estradiol) vs. Early follicular phase (low estradiol) was evaluated on Flow-mediated dilatation (FMD) after ischemia and reperfusion (p=0.03). The late follicular phase of the menstrual cycle, characterized by high estradiol levels, preserved flow-mediated dilatation after ischemia-reperfusion injury compared to the early follicular phase (7.0% vs 3.6%, p=0.03).
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