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Sex differences in central hemodynamics and their relationship to left ventricular diastolic function

 Chi Young Shim  ;  Sungha Park  ;  Donghoon Choi  ;  Woo-In Yang  ;  In-Jeong Cho  ;  Eui-Young Choi  ;  Namsik Chung  ;  Jong-Won Ha 
 Journal of the American College of Cardiology, Vol.57(10) : 1226-1233, 2011 
Journal Title
 Journal of the American College of Cardiology 
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OBJECTIVES: This study aimed to investigate sex differences in the association between arterial stiffness and left ventricular (LV) diastolic dysfunction. BACKGROUND: Heart failure with preserved ejection fraction is more common in women. Arterial stiffness has been suggested as a significant contributor to the development of heart failure. We hypothesized that the association between arterial stiffness and LV diastolic function would be stronger in women than in men. METHODS: Two-dimensional, Doppler echocardiography and radial artery tonometry were performed simultaneously in 158 age-matched subjects (79 males, 79 females; mean age: 58 ± 10 years) without any structural heart disease or LV systolic dysfunction. RESULTS: The peripheral blood pressure and pulse pressure (PP) were similar between sexes. However, central PP and augmentation index were significantly higher and PP amplification was significantly lower in women (1.31 vs. 1.19, p < 0.001). The associations of PP amplification with early diastolic mitral annular (Em) velocity and transmitral to mitral annular early diastolic velocity ratio (E/Em) were significant in women (r = 0.38, p = 0.001; r = -0.36, p = 0.001), whereas no significant association was found in men (r = 0.09, p = 0.428, r = -0.14, p = 0.215). Multiple regression analysis revealed that PP amplification had an independent correlation with Em velocity only in women. CONCLUSIONS: Despite similar peripheral PP, the central hemodynamics reflecting arterial stiffness were different between men and women. LV diastolic function correlates significantly with the parameters representing arterial stiffness only in women. We suggest that the effects of earlier wave reflection on central pressure may contribute to greater susceptibility to heart failure with preserved LV ejection fraction in women.
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1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
박성하(Park, Sung Ha) ORCID logo https://orcid.org/0000-0001-5362-478X
심지영(Shim, Chi Young) ORCID logo https://orcid.org/0000-0002-6136-0136
양우인(Yang, Woo In)
정남식(Chung, Nam Sik)
조인정(Cho, In Jeong)
최동훈(Choi, Dong Hoon) ORCID logo https://orcid.org/0000-0002-2009-9760
최의영(Choi, Eui Young) ORCID logo https://orcid.org/0000-0003-3732-0190
하종원(Ha, Jong Won) ORCID logo https://orcid.org/0000-0002-8260-2958
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