Key result
Female sex linked to ~46% lower cardiomegaly risk in long-term high-altitude residents.
Why the study?
Gender differences in cardiac remodeling due to chronic hypoxia among long-term high-altitude residents remained to be investigated using CMR.
Cross-Sectional (n=89)
No
Female sex is associated with a significantly lower risk of hypoxia-induced cardiac enlargement compared to males among long-term high-altitude residents.
Female sex may protect against cardiomegaly in high-altitude residents; leaves open causal confirmation and broader applicability.
Purpose: The purpose of this study is to investigate gender differences in cardiac remodeling due to hypoxia, using cardiac magnetic resonance (CMR) in individuals living at high altitudes for extended periods. Materials and Methods: The study cohort consisted of 89 healthy high-altitude residents, categorized by sex: 49 males (55.1%) and 40 females (44.9%). We conducted comparative analyses of clinical demographics and CMR-derived structural indices within the study cohort. Single-variable logistic regression revealed significant associations, which were later confirmed using adjusted multivariable modeling to identify independent predictors. Key Results: Being female is associated with a 59.4% lower risk of cardiomegaly compared to males (OR = 0.538, 95% CI = 0.279 - 0.875, p = 0.006). BMI independently predicts the risk of cardiac enlargement (OR = 0.632, 95% CI = 1.088 - 1.536, p = 0.003). The diameter of the principal pulmonary artery showed the strongest association (OR = 0.988, 95% CI = 0.988 - 1.346, p = 0.007). Conclusions: Multivariate logistic regression analysis indicates that sex, body mass index (BMI), and primary pulmonary artery diameter are independent risk factors contributing to cardiac enlargement in high-altitude regions. Given the observed cardioprotective role of female sex in high-altitude populations, we hypothesize that female gender status, BMI range, and main pulmonary artery diameter synergistically influence susceptibility to hypoxia-induced cardiac remodeling in prolonged high-altitude residents. These findings not only provide a solid foundation for preventing chronic heart disease but also support the implementation of tailored treatment interventions in high-altitude areas.
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Shen et al. (2025) conducted a cross-sectional in Healthy high-altitude residents (chronic hypoxia exposure) (n=89). Female sex vs. Male sex was evaluated on Cardiac enlargement (cardiomegaly) (OR 0.538, 95% CI 0.279 - 0.875, p=0.006). Being female is associated with a significantly lower risk of cardiomegaly compared to males among long-term high-altitude residents (OR 0.538).
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