Tibolone Improves Myocardial Perfusion in Postmenopausal Women With Ischemic Heart Disease

Campisi, Roxana; Camilletti, Jorge; Mele, Aníbal A.; Erriest, Juan; Pedroni, Pablo; Guiglioni, Ariel

doi:10.1016/j.jacc.2005.09.033

Cited by 8 publications

(4 citation statements)

References 11 publications

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“…From these alternatives of HRT, only the effect of tibolone on the microcirculation has been explored by nuclear imaging. In a recent pilot study (61), 6 months of treatment with tibolone decreased the extent and severity of myocardial perfusion defects during stress as well as the ‘amount of ischaemia’ in postmenopausal women with IHD, as assessed by SPECT imaging. Whether such improvement in the ‘amount of ischaemia’ after tibolone therapy reduces clinical coronary events needs to be determined.…”

Section: Effects Of Hormone Replacement Therapy On Coronary Vascular mentioning

confidence: 99%

Noninvasive assessment of coronary microvascular function in women at risk for ischaemic heart disease

Campisi

2007

International Journal of Clinical Practice

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The primary objective of the current review is to describe the assessment of coronary microvascular function by noninvasive imaging techniques in women at risk for and with ischaemic heart disease (IHD). The search criteria were the analyses of the related bibliography published in PUBMED database. Normal or minimal obstructive coronary artery disease (CAD) at angiography is a common finding in women with signs of ischaemia. Up to 50% of them will have coronary microvascular dysfunction, suggesting that the mechanism of ischaemia may be localised at coronary microcirculation level. Noninvasive measurements of coronary microvascular function can be performed by radionuclide techniques. In particular, positron emission tomography (PET) measures myocardial blood flow (MBF) not only relatively but also in absolute units. Thus, PET offers the possibility to uncover microvascular dysfunction even in patients without obstructive CAD. PET-derived estimates of MBF showed an abnormal coronary microvascular function in women with chest pain and non-obstructive CAD and in women with high-risk conditions for CAD. Interestingly, there is a relationship between an abnormal coronary vascular function and adverse cardiovascular outcomes. In particular, this significant relationship was observed with measurements related to endothelial function. Recent evidence suggests that vascular dysfunction plays a central role as an estimator of outcomes in women at risk for or with IHD. Therefore, assessment of coronary vascular function in these women appears to be of clinical relevance. Whether such evaluation may have an impact to reduce cardiac events needs further investigation.

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Section: Effects Of Hormone Replacement Therapy On Coronary Vascular mentioning

confidence: 99%

Noninvasive assessment of coronary microvascular function in women at risk for ischaemic heart disease

Campisi

2007

International Journal of Clinical Practice

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“…There was, however, evidence that T may possess anti-ischemic effects. Indeed, a prospective randomised open-label pilot study performed in PMW with ischemic heart disease demonstrated that 6 months of T significantly improved stress myocardial perfusion defects, as well as the 'amount of ischemia' as assessed by SPECT imaging [59]. Thus, T may exert a favourable effect on CV secondary prevention by improving myocardial perfusion in PMW with cardiac perfusion defect.…”

Section: Peripheral and Coronary Arteriesmentioning

confidence: 99%

Tibolone in postmenopausal women: a review based on recent randomised controlled clinical trials

Biglia

Maffei

Lello

et al. 2010

Gynecological Endocrinology

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“…More recently, a prospective randomized open-label pilot study was performed in 26 postmenopausal women not on HRT referred for a clinically indicated single-photon emission computed tomography (SPECT) myocardial perfusion study with stress-induced perfusion defects (Campisi et al 2006). All had cessation of menses ≥1 year, a normal mammogram, breast and pelvic examinations and pap smear within 6 months of the study.…”

Section: R Campisi and F D Marengomentioning

confidence: 99%

Cardiovascular Effects of Tibolone: A Selective Tissue Estrogenic Activity Regulator

Campisi

Marengo

2007

Cardiovascular Drug Reviews

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Traditionally, it was accepted that long-term hormone replacement therapy (HRT) has a cardiovascular beneficial effect in postmenopausal women with and without coronary artery disease (CAD). However, randomized trials in postmenopausal women have not shown any benefit in either primary or secondary prevention of cardiovascular events. Therefore, these findings have raised the question of whether traditional HRT (i.e., estrogen and progesterone) has a cardioprotective effect in women at risk for or with established CAD. Concerns about the use of conventional HRT have led to a search for alternatives. Tibolone is a synthetic compound with estrogenic, androgenic, and progestogenic properties that relieves climacteric symptoms and prevents postmenopausal bone loss. Tibolone possesses a tissue-selective mechanism of action that differs from that of estrogen and/or progestogen. Unlike these compounds, tibolone's metabolites play a central role in its mode of action. Tibolone is widely used for HRT. However, its clinical impact on cardiovascular disease is still under study. The current review focuses on the effects of tibolone on the cardiovascular system and discusses clinical investigations with this compound in postmenopausal women.

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Tibolone Improves Myocardial Perfusion in Postmenopausal Women With Ischemic Heart Disease

Abstract: In postmenopausal women with ischemic heart disease, six months of therapy with tibolone significantly improved stress myocardial perfusion and the "amount of ischemia."

Cited by 8 publications

References 11 publications

Noninvasive assessment of coronary microvascular function in women at risk for ischaemic heart disease

Noninvasive assessment of coronary microvascular function in women at risk for ischaemic heart disease

Tibolone in postmenopausal women: a review based on recent randomised controlled clinical trials

Cardiovascular Effects of Tibolone: A Selective Tissue Estrogenic Activity Regulator

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