Abstract 3188: Gender Difference in Central Hemodynamics and Its Relationship With Left Ventricular Diastolic Function in Subjects With Preserved Ejection Fraction
Backgrounds Heart failure (HF) with preserved ejection fraction is more common in women. Arterial stiffness has been suggested to be a significant contributor in the development of HF. Because there exist gender differences in pulsatile vascular load, women have inappropriately high vascular loading conditions compared with those in men. Thus, we hypothesized that the effects of arterial stiffness on the left ventricular (LV) diastolic dysfunction would be stronger in women than in men.
Methods 175 subjects (66 men, mean age 57±11 years) who were referred to echocardiography laboratory were consecutively enrolled. The patients who had any structural heart diseases, LV systolic dysfunction (LV ejection fraction <55 %), and significant arrhythmias were excluded. Echocardiography and radial artery tonometry were simultaneously performed. 96 patients (48 men; 48 women, mean age 57±10 years) were selected for analysis of gender differences of arterial stiffness and the effects on the LV diastolic function after age- and gender-match.
Results Although peripheral blood pressure (BP) and pulse pressure (PP) were similar between men and women, the central systolic BP and PP were significantly higher in women (121±10 vs. 117±9 mmHg, p=0.012 ; 46±5 vs. 40±4 mmHg, p=0.006) when compared to men. PP amplification, defined as the ratio of peripheral PP to central PP, was significantly lower in women (1.19±0.12 vs. 1.32±0.14, p<0.001). The augmentation index at the heart rate of 75 was higher in women (31.2±11.3 vs. 20.5±10.3 %. p<0.001). There were significant correlations between PP amplification and left atrial volume index and E′ in women (r=−0.447, p=0.001; r=0.487, p<0.001) whereas no correlation was found between these parameters in men (r=−0.271, p=0.062, r=0.098, p=0.507).
Conclusion In women, despite similar peripheral hemodynamics, there are significant differences in central hemodynamics. The LV diastolic function correlates with central hemodynamics in women but not in men. These findings may suggest that women have a susceptibility to diastolic dysfunction relating to central arterial stiffening. And thus it can be one of important mechanisms of HF with preserved ejection fraction in women.