Abstract 15259: Sex Differences in Left Atrial Electroanatomical Remodeling and Their Relationship to Left Ventricular Diastolic Function in Patients with Atrial Fibrillation
Background It has been reported that women are more susceptible to the preserved ejection fraction heart failure and diastolic dysfunction than men, and determined as a risk factor in CHA2DS2-VAS score for the patients with atrial fibrillation (AF). We hypothesized that the nature of left atrial (LA) electroanatomical remodeling can be affected by LV diastolic function and different in male and female patients with AF.
Methods We included 179 female (59.2±10.8 years old, paroxysmal AF (PAF) 73.7%) and age-and AF type-matched 451 male patients with AF (59.2±8.8 years old, PAF 73.6%) who underwent radiofrequency catheter ablation (RFCA) of AF. Echocardiographic parameters determining LA and LV function, Cardiac CT, endocardial voltage measured by NavX, and the clinical outcome were compared between female and male.
Results 1. In spite of similar CHADS2 score (0.91±1.02 vs. 0.90±1.05, p=0.958), female patients with AF had higher LA volume indices measured by echo (36.9±12.1 vs.33.5±11.9mL/m2, p=0.002) and CT (75.9±25.2 vs.68.7±20.4mL/m2, p=0.001) and significantly lower LA endocardial voltage (0.90±0.46 vs.1.30±0.62mV, p<0.001) than age matched male patients. 2. Female AF had higher E/E’ (12.3±5.0 vs. 10.0±4.5, p<0.001), E velocity (0.79±0.24 vs. 0.69±0.20m/s, p<0.001) in mitral flow pattern, and ejection fraction (EF; 64.8±8.2% vs. 63.0±8.8%, p=0.022) than in men. 3. During 14.6±8.7 months follow-up, clinical recurrence rates of AF were not significantly different between female (19.0%) and male (18.6%, p=0.257).
Conclusion The female patients with AF had more advanced degree of electroanatomical remodeling of LA associated with higher E/E’ compared with age- and AF type-matched male patients. This finding may suggest the potential reason for higher CHA2DS2-VASC score in women.
- © 2012 by American Heart Association, Inc.