Abstract 18592: Gender-specific Differences in Phenotypes of Left Ventricular Hypertrophy
Background: Left ventricular hypertrophy (LVH) is independently associated with cardiovascular endpoints, including coronary heart disease and stroke. Gender-specific knowledge about phenotypes of LVH is still very limited.
Objectives: To determine gender-specifically the distribution of phenotypes of left ventricular hypertrophy, to evaluate the associations with cardiovascular (CV) risk factors and diseases, as well as subtypes of cardiac dysfunction.
Methods: The age- and gender-stratified, population-based Gutenberg-Heart Study was base for an analysis of 5.000 participants, examined from 2007 to 2008. Computer-assisted personal interview, clinical parameters, blood sampling and echocardiograms were assessed according to standard operating procedures with detailed quality control.
Results: The sample was predominantly white and of European ancestry and comprised 2460 women and 2540 men, aged 35 to 74 years. Concentric remodelling (CR) was more frequent in men (M) than in women (W; M 7.9% vs. W 7.2%); LVH, however, was more frequent in women (W 14.8% vs. M 10.4%), as also its subtypes, concentric hypertrophy (ConH; W 3.5% vs. M 2.9%) and eccentric hypertrophy (EccH; W 11.3% vs. M 7.5%, all p<0.0001). For all CV risk factors, an increasing value of the risk factor was associated with an incremental presence of LVH. Multivariate logistic regression models showed varying associations of CR, ConH and EccH with risk factors between genders. This was also found for associations of LVH subtypes with CV diseases under adjustment for CV risk factors. EccH was more often associated with cardiac dysfunction in men (M 50.9% vs. W 36.5%), whereas ConH was in women (M 41.4% vs. W 50.6%, all p<0.0001). For diastolic dysfunction, the LV filling index E/E' reflecting the left ventricular enddiastolic pressure showed increasing values from normal geometry to CR to EccH with highest values in ConH for both genders. Ejection fraction was the lowest in EccH.
Conclusion: The gender- specific distributions of LVH phenotypes differ in the population. Subtypes of left ventricular hypertrophy vary gender-specifically in their associations with cardiovascular risk factors and diseases as well as in the prevalence of phenotypes of cardiac dysfunction.
- © 2010 by American Heart Association, Inc.