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

ChiYoung Shim, Sungha Park, Donghoon Choi, Woo In Yang, In Jeong Cho, Eui Young Choi, Namsik Chung, Jong Won Ha

Research output: Contribution to journalArticle

104 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)1226-1233
Number of pages8
JournalJournal of the American College of Cardiology
Volume57
Issue number10
DOIs
Publication statusPublished - 2011 Mar 8

Fingerprint

Left Ventricular Function
Sex Characteristics
Vascular Stiffness
Hemodynamics
Blood Pressure
Heart Failure
Left Ventricular Dysfunction
Radial Artery
Doppler Echocardiography
Manometry
Stroke Volume
Heart Diseases
Regression Analysis
Pressure

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Shim, ChiYoung ; Park, Sungha ; Choi, Donghoon ; Yang, Woo In ; Cho, In Jeong ; Choi, Eui Young ; Chung, Namsik ; Ha, Jong Won. / Sex differences in central hemodynamics and their relationship to left ventricular diastolic function. In: Journal of the American College of Cardiology. 2011 ; Vol. 57, No. 10. pp. 1226-1233.
@article{f5929f63fa0e414dac11fa28357ab354,
title = "Sex differences in central hemodynamics and their relationship to left ventricular diastolic function",
abstract = "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.",
author = "ChiYoung Shim and Sungha Park and Donghoon Choi and Yang, {Woo In} and Cho, {In Jeong} and Choi, {Eui Young} and Namsik Chung and Ha, {Jong Won}",
year = "2011",
month = "3",
day = "8",
doi = "10.1016/j.jacc.2010.09.067",
language = "English",
volume = "57",
pages = "1226--1233",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "10",

}

Sex differences in central hemodynamics and their relationship to left ventricular diastolic function. / Shim, ChiYoung; Park, Sungha; Choi, Donghoon; Yang, Woo In; Cho, In Jeong; Choi, Eui Young; Chung, Namsik; Ha, Jong Won.

In: Journal of the American College of Cardiology, Vol. 57, No. 10, 08.03.2011, p. 1226-1233.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Sex differences in central hemodynamics and their relationship to left ventricular diastolic function

AU - Shim, ChiYoung

AU - Park, Sungha

AU - Choi, Donghoon

AU - Yang, Woo In

AU - Cho, In Jeong

AU - Choi, Eui Young

AU - Chung, Namsik

AU - Ha, Jong Won

PY - 2011/3/8

Y1 - 2011/3/8

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=79952291627&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79952291627&partnerID=8YFLogxK

U2 - 10.1016/j.jacc.2010.09.067

DO - 10.1016/j.jacc.2010.09.067

M3 - Article

C2 - 21371640

AN - SCOPUS:79952291627

VL - 57

SP - 1226

EP - 1233

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

SN - 0735-1097

IS - 10

ER -