Menstrual Cyclic Variation of Myocardial Ischemia in Premenopausal Women with Variant Angina
- Hiroaki Kawano, MD, PhD;
- Takeshi Motoyama, MD, PhD;
- Masamichi Ohgushi, MD, PhD;
- Kiyotaka Kugiyama, MD, PhD;
- Hisao Ogawa, MD, PhD; and
- Hirofumi Yasue, MD, PhD
- From Kumamoto University School of Medicine, Kumamoto Regional Medical Center, and Kumamoto Aging Research Institute, Kumamoto, Japan.
Abstract
Background: An abundance of ovarian hormones is assumed to be a major contributor to the low incidence of ischemic heart disease in premenopausal women. However, the effects of ovarian hormones remain undetermined.
Objective: To examine whether the variation in ovarian hormone levels throughout a menstrual cycle affects myocardial ischemia in women with variant angina.
Design: Prospective, observational study.
Setting: University medical center in Japan.
Participants: 10 premenopausal women with variant angina.
Measurements: Frequency of spontaneous ischemic episodes, flow-mediated dilation of brachial artery, and serum levels of estradiol and progesterone.
Results: Frequency of ischemic episodes was highest from the end of the luteal phase to the beginning of the menstrual phase and was lowest in the follicular phase. Flow-mediated vasodilation and estradiol levels were lowest from the end of the luteal phase to the beginning of the menstrual phase and were highest in the follicular phase.
Conclusions: In premenopausal women with variant angina, we documented a cyclic variation in endothelial function and the frequency of myocardial ischemia that was associated with the variation in estrogen levels.
Article and Author Information
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Acknowledgments: The authors thank the patient volunteers for their outstanding patience and generosity, Yasunori Uragari for expert assistance with statistical analysis, and Noriko Kawano for help in many ways.
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Grant Support: By a Grant for Clinical Vascular Function and by a Grant-in-Aid for Scientific Research (A12770346) from the Ministry of Education, Science, and Culture, Japan.
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Requests for Single Reprints: Hiroaki Kawano, MD, PhD, Department of Cardiovascular Medicine, Kumamoto University School of Medicine, 1-1-1 Honjo, Kumamoto City 860-8556, Japan; e-mail, koumei{at}gpo.kumamoto-u.ac.jp.
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Current Author Addresses: Drs. Kawano, Motoyama, Kugiyama, and Ogawa: Department of Cardiovascular Medicine, Kumamoto University School of Medicine, 1-1-1 Honjo, Kumamoto City 860-8556, Japan.
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Dr. Ohgushi: Kumamoto Regional Medical Center, 5-16-10 Honjo, Kumamoto City 860-0811, Japan.
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Dr. Yasue: Kumamoto Aging Research Institute, 6-8-1 Yamamuro, Kumamoto City 860-8518, Japan.
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Author Contributions: Conception and design: H. Kawano, H. Yasue.
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Analysis and interpretation of the data: H. Kawano, T. Motoyama,
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Drafting of the article: H. Kawano, H. Yasue.
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Critical revision of the article for important intellectual content: H. Kawano.
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Final approval of the article: H. Kawano, T. Motoyama, M. Ohgushi, K. Kugiyama, H. Ogawa, H. Yasue.
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Provision of study materials or participants: H. Kawano, T. Motoyama, M. Ohgushi, K. Kugiyama, H. Ogawa, H. Yasue.
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Statistical expertise: H. Kawano.
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Obtaining of funding: H. Kawano, H. Yasue.
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Administrative, technical, or logistic support: K. Kugiyama, H. Ogawa, H. Yasue.
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Collection and assembly of data: H. Kawano, T. Motoyama, M. Ohgushi.
- Copyright ©2004 by the American College of Physicians
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