Older women without cardiovascular disease had superior aortic global longitudinal strain (6.16% vs. 5.21%, P=0.030) and ventriculoarterial coupling compared to men, independent of body size and DBP.
Cross-Sectional (n=202)
Are there sex differences in CMR-derived aortic global longitudinal strain and ventriculoarterial coupling, and how do they correlate with Framingham 10-year risk scores in older adults without cardiovascular disease?
CMR-derived aortic longitudinal strain and ventriculoarterial coupling are superior in older women compared to men and correlate better with Framingham risk scores, potentially aiding in cardiovascular risk stratification.
Absolute Event Rate: 6.16% vs 5.21%
p-value: p=0.030
Abstract Aims Traditional risk factors do not fully characterize cardiovascular aging and are less helpful in assessing sex differences in cardiovascular risk. Using a novel cardiovascular magnetic resonance (CMR) method, we determined sex differences in aortic global longitudinal strain (AOGLS) and ventriculoarterial coupling (VAC) with correlations to Framingham risk scores. Methods and results Community older adults without cardiovascular disease underwent CMR. AOGLS was the maximal absolute Lagrangian strain between the brachiocephalic artery and aortic annulus. VAC was aortic pulse wave velocity (AAPWV) divided by LVGLS. Among 202 participants (46.0% female, 70.2 ± 8.8 years), women had lower diastolic blood pressure (DBP) (70.5 ± 10.8 mmHg vs. 78.1 ± 9.5 mmHg, P 0.001), body surface area (BSA) (1.52 ± 0.12 m2 vs. 1.70 ± 0.14 m2, P 0.001), and fewer smokers (3.2% vs. 25.7% P 0.001) than men, despite similar ages. Women had better AAPWV (8.41 ± 2.73 m/s vs. 9.13 ± 3.18 m/s, adj. P = 0.020), AOGLS (6.16 ± 2.44% vs. 5.21 ± 1.74%, adj. P = 0.030), LVGLS (−21.93 ± 2.59 vs. −20.06 ± 2.79%, adj. P = 0.021), VAC (−0.39 ± 0.15 vs. −0.47 ± 0.21, adj. P = 0.006), and smaller indexed cardiac volumes. Female sex was associated with better AOGLS (β = 0.838, adj. P = 0.030; R2 = 0.103) and VAC (β = −0.093, adj. P = 0.006; R2 = 0.113) independent of smoking, DBP, and BSA. Among women, AOGLS was moderately correlated with 10-year risks (r = −0.400 P = 0.001) and VAC was associated with 10-year risks (β = −6.915, adj. P = 0.017; R2 = 0.145). Conclusion Novel CMR-derived aortic longitudinal strain differentiated ventriculo-aortic aging between the sexes. Women had superior AOGLS and VAC, independent of body size and DBP, that correlated better with Framingham risk scores compared to men. Impaired AOGLS and VAC may be useful in differentiating individuals at intermediate from low-borderline cardiovascular risk. Trial registration: ClinicalTrials.gov Identifier: NCT02791139
Wong et al. (Wed,) conducted a cross-sectional in Community older adults without cardiovascular disease (n=202). Female sex vs. Male sex was evaluated on Aortic global longitudinal strain (AOGLS) (p=0.030). Older women without cardiovascular disease had superior aortic global longitudinal strain (6.16% vs. 5.21%, P=0.030) and ventriculoarterial coupling compared to men, independent of body size and DBP.
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