Gender-Specific Differences in Myocardial Deformation and Aortic Stiffness at Rest and Dobutamine Stress

Elderly women have increased aortic and ventricular stiffness but preserved global systolic function. Possible gender differences in ventricular deformation attributed to increased aortic stiffness at rest or with positive inotropic stress remain unknown. Eighty-four subjects (mean age: 63±8 years) were assessed for aortic stiffness by pulse wave velocity and ventricular deformation at rest and during dobutamine stress using magnetic resonance. At rest, women (n=40) had greater aortic stiffness and ventricular deformation than men (P<0.05). In men, dobutamine increased longitudinal (mean±SD: 3.3±4.1%; P<0.01) and circumferential deformation (2.9±5.1%; P=0.007), whereas women showed an increase in circumferential deformation only (4.8±6.3%; P<0.01). In men there was an inverse association between longitudinal deformation and pulse wave velocity at rest (r=-0.51; P=0.002) and linear at stress (r=0.52; P=0.001). In women there were no significant relations at rest, whereas at stress longitudinal deformation was inversely associated with pulse wave velocity (r=-0.43; P=0.02). We demonstrate gender-specific differences in the relationship between aortic stiffness and ventricular deformation at rest and during dobutamine stress. Although at rest longitudinal deformation is inversely related to aortic stiffness in men, there is no such relationship in women. At stress, men improve longitudinal function, whereas in women such response is limited.