Sex Differences in Heart Failure With Preserved Ejection Fraction Pathophysiology: A Detailed Invasive Hemodynamic and Echocardiographic Analysis

JACC. Heart Failure
Anna L BealeDavid M Kaye

Abstract

This study sought to identify sex differences in central and peripheral factors that contribute to the pathophysiology of heart failure with preserved ejection fraction (HFpEF) by using complementary invasive hemodynamic and echocardiographic approaches. Women are overrepresented among patients with HFpEF, and there are established sex differences in myocardial structure and function. Exercise intolerance is a fundamental feature of HFpEF; however, sex differences in the physiological determinants of exercise capacity in HFpEF are yet to be established. Patients with exertional intolerance with confirmed HFpEF were included in this study. Evaluation of the subjects included resting and exercise hemodynamics, echocardiography, and mixed venous blood gas sampling. A total of 161 subjects included 114 females (71%). Compared to males, females had a higher pulmonary capillary wedge pressure (PCWP) indexed to peak exercise workload (0.8 [0.5 to 1.2] mm Hg/W vs. 0.6 [0.4 to 1] mm Hg/W, respectively; p = 0.001) and lower systemic (1.1 [0.9 to 1.5] ml/mm Hg vs. 1 [0.7 to 1.2] ml/mm Hg, respectively; p = 0.019) and pulmonary (2.9 [2.2 to 4.2] ml/mm Hg vs. 2.4 [1.9 to 3] ml/mm Hg, respectively; p = 0.032) arterial compliance at exercise....Continue Reading

Citations

Dec 5, 2019·European Heart Journal·Carolyn S P LamAdriaan A Voors
Feb 27, 2020·Heart·Felice L Gersh, Carl J Lavie
May 22, 2020·Circulation Research·Rebecca H Ritchie, E Dale Abel
Aug 10, 2020·The Journal of Clinical Endocrinology and Metabolism·Di ZhaoErin D Michos
Sep 24, 2020·Biomedicines·Anne-Kristin SchaeferMarkus Mach
Jun 7, 2019·Journal of Clinical Medicine·Marijana TadicMaurizio Galderisi
Feb 2, 2020·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Masatake KobayashiNicolas Girerd
Sep 2, 2019·Heart Failure Clinics·Jennifer Ballard-Hernandez, Dipti Itchhaporia
Feb 24, 2021·Journal of the American Heart Association·Yohei SotomiUNKNOWN PURSUIT‐HFpEF Investigators
Mar 3, 2021·Scientific Reports·Minkwan KimHyung-Kwan Kim
Mar 13, 2021·ESC Heart Failure·Caroline EspersenElke Platz
Mar 19, 2021·Cardiovascular Research·Saraschandra VallabhajosyulaVirginia M Miller
May 8, 2021·The Journal of Clinical Hypertension·Anping CaiYingqing Feng
Jun 15, 2021·Frontiers in Physiology·Natacha FournyLuc Bertrand
Jul 3, 2021·Journal of the American Heart Association·Anna L BealeDavid M Kaye
Jul 27, 2021·Heart & Lung : the Journal of Critical Care·Kristen A Sethares, Elizabeth Chin
Aug 29, 2021·Heart, Lung & Circulation·Ute SeelandUNKNOWN Sex and Gender VascAgeNet Expert Group

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