Superior aortic strain and ventriculoarterial coupling in older women are moderately correlated with Framingham 10-year risk

Figures

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  Figure 1. Sex differences in age-associated decline in aortic strain and ventriculoarterial coupling. Scatterplots of AOGLS (A) and VAC (B) with increasing age, plotted with least-squares fit line (solid), and 95% confidence intervals (dotted) for women (n = 93) (red) and men (n = 109) (orange). Based on the datapoint distributions, linear, and quadratic equations were fitted to AOGLS and VAC, respectively. AOGLS declined with increasing age in both sexes. However, the decline in AOGLS was steeper in women and exceeded men at the seventh decade of life. VAC, representing cardiovascular mechanical efficiency, also declined with age in both sexes but plateaued after the seventh decade in women.

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  Figure 2. Differences in ascending aortic global longitudinal strain and ventriculoarterial coupling. Participants were divided into four age categories: 54 years and below (5 females, 4 males); 55–64 years (4 females, 6 males); 65–74 years (60 females, 66 males); and 75 years and above (24 females, 33 males). Sex-specific mean AOGLS (A) and VAC (B) with 95% confidence are represented by error bars for each age category (red for women, orange for men). At a younger age, women had better aortic compliance compared to men, represented by better AOGLS (54 years and below, P = 0.027; 65–74 years, P = 0.018). With aging, AOGLS decreased in both sexes but the difference between sexes narrowed. Above the age of 75 years, the sex difference in AOGLS was not significant (P = 0.073). In comparison, mean VAC decreased with aging in both sexes, but the difference was non-significant before the 7th decade of life. Above the age of 75 years, women had significantly better VAC than compared to men (P = 0.011).

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  Figure 3. Comparing ascending aortic longitudinal strain and ventriculoarterial coupling between the sexes with Framingham risk scores. Participants were grouped based on their Framingham 10-year risk scores into low-borderline (<7.5%) (8 females, 3 males), intermediate (≥7.5% to 20%) (22 females, 4 males), and high (≥20%) (63 females, 102 males) risk groups. Comparisons for AOGLS (A) and VAC (B) were made between sexes within each risk category. Both women and men in the intermediate risk category had poorer aortic compliance, represented by lower AOGLS, compared to women and men in the low-borderline risk category (women P < 0.001; men P = 0.034). VAC was also poorer for both sexes in the intermediate risk category compared to the low-borderline risk category (women P < 0.001; men P = 0.034). There were no significant differences in AOGLS or VAC between the high and intermediate risk categories. In high-risk category, women were distinguished by better AOGLS (P = 0.010) and VAC (P = 0.008) than compared to men.