February 23, 2014European Journal of Heart Failure
Sex-Specific Cardiovascular Structure and Function in Heart Failure with Preserved Ejection Fraction
Why the study?
Do cardiovascular structure and function differ between men and women with heart failure with preserved ejection fraction?
Population
279 patients with heart failure with preserved ejection fraction from the PARAMOUNT study with analysable…
Comparison
Female sex vs Male sex
Design
Cohort
Follow-up
up to 36 weeks
Authors
Discussion
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Member takes
Implication
Supports closer diastolic monitoring in women with HFpEF; leaves open whether sex-specific therapies are warranted.
Key Points
- To evaluate the relationship between sex and cardiovascular structure and function in patients diagnosed with heart failure with preserved ejection fraction.
- Analyzed baseline and follow-up echocardiographic data from 279 participants (57% women, mean age 71 years, 94% hypertensive, 38% diabetic) enrolled in the PARAMOUNT trial.
- Assessed sex differences in clinical characteristics, left ventricular geometry, tissue Doppler velocities, myocardial strain, and arterial-ventricular coupling at baseline, 12 weeks, and 36 weeks.
- Women had significantly worse diastolic function (lower E', P = 0.002; higher E/E', P < 0.001) and increased left ventricular wall thickness, despite similar height-indexed left ventricular mass and volumes compared with men.
- Left ventricular diastolic and systolic stiffness were significantly higher in women than in men (P < 0.001), remaining significant after adjusting for ventricular concentricity and clinical covariates.
- Abnormal left ventricular geometry was more prevalent in women at baseline (unadjusted P = 0.028, adjusted P = 0.056) and at 12 weeks (adjusted P = 0.006), but this difference attenuated by 36 weeks (adjusted P = 0.99).
Structured PICO
Do cardiovascular structure and function differ between men and women with heart failure with preserved ejection fraction?
P
Population
279 patients with heart failure with preserved ejection fraction (HFpEF) from the PARAMOUNT study with analysable baseline echocardiograms, mean age 71 years, 57% women, 94% hypertensive, 38% diabetic.
I
Intervention
Female sex
C
Comparator
Male sex
O
Outcome
Sex-based differences in baseline clinical characteristics and measures of cardiovascular structure and function (including LV wall thickness, diastolic function, LV mass, LV volumes, LV geometry, LV strain, stiffness, and arterial-LV coupling)surrogate
Women with HFpEF exhibit more pronounced diastolic dysfunction and higher ventricular stiffness compared to men, which may contribute to their greater predisposition to the disease.
Cite This Study
Gori et al. (2014) studied this question.