Key result
Low cardiac output tracks with end-diastolic volume in men but heart rate in women.
Why the study?
Sex differences in the determinants of cardiac output using cardiac magnetic resonance imaging were not well characterized.
Cross-Sectional (n=268)
No
This study highlights important sex differences in cardiac physiology, demonstrating that in low cardiac output states, output is driven more strongly by end-diastolic volume in males and by heart rate in females.
Sex-specific CO thresholds may aid identification of high-output states; leaves open whether determinants predict outcomes or guide therapy.
Background This study investigates sex differences in the determinants of cardiac output (CO) using cardiac magnetic resonance imaging (CMR). Methods This is a single centre, cross-sectional study of 268 adults (43% female, 59 ± 10 years) from the Courtois Cardiovascular Signature Program. Participants were stratified into below and above mean CO groups using predefined sex-specific thresholds (6.0 L/min in males, 4.9 L/min in females). Multivariable regression and interaction analyses assessed associations between CO and heart rate (HR), end-diastolic volume (EDV), and body surface area (BSA) by sex. Results Among males with below mean CO, EDV and HR were independently associated with CO (EDV: β = 0.42, CI [0.241, 0.592], p < 0.001; HR: β = 0.21, CI [0.037, 0.385], p=0.018). In below mean CO females, only HR was independently associated with CO (β = 0.26, CI [0.023, 0.490], p=0.032). In the above mean CO group, only HR was independently associated with CO in males, while in females, both HR and EDV were associated; BSA was not associated in either sex. Interaction analysis revealed a stronger EDV-CO relationship in below vs above mean CO states among males (p = 0.010), whereas no significant interactions were observed in females. Conclusion These findings reveal sex-specific patterns of association in the determinants of CO, with CO more strongly associated with EDV in males and HR in females in low output states.
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Zuberi et al. (2026) reported a cross-sectional. Heart rate, end-diastolic volume, and body surface area was evaluated on Determinants of cardiac output (CO) by sex in below and above mean CO groups. In low cardiac output states, cardiac output was more strongly associated with end-diastolic volume in males (β = 0.42; p < 0.001) and with heart rate in females (β = 0.26; p = 0.032).
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