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Left Ventricular Diastolic Elastance is Higher in Women Compared to Men, and Elevated with Beta‐blockade
Author(s) -
Kerkhof Peter,
Li John,
Kresh J,
Heyndrickx Guy
Publication year - 2015
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.29.1_supplement.799.5
Subject(s) - medicine , cardiology , diastole , heart failure , blood pressure
BACKGROUND Left ventricular (LV) end‐diastolic elastance (EDE) alters in heart failure (HF). Yet, gender, age, and beta‐blocker (BB) are never studied at different LV filling levels. METHODS We analyzed LV end‐diastolic pressure (EDP, mmHg, by catheterization), and end‐diastolic volume index (EDVI, mL/m 2 from ventriculography) in 1459 patients with various types of cardiac disease. EDE (mmHg.m 2 /mL) was compared after stratification for gender, BB use, and level of filling pressure (denoted as EDP+ if > 16 mmHg, i.e. HF candidates). RESULTS For women (n=502) mean EDE=.2459 (95% CI .2349‐.2570) is higher (P<.0001) compared to men (n=957) with .2114 (95% CI .2046‐.2182). In women with BB mean EDE is .2474 (n=437), higher than in their control group .2365 (n=65), and likewise in men with BB where mean EDE is .2133 (n=866) relative to EDE=.1936 in their controls (n=91). Multiple regression yields for BB: EDE=.194 (P<.0001) ‐ .031 sex (P<.0001) + .001 age (P<.009), n=1303. This contrasts the control group (n=156) where EDE = .141 (P<.026), regardless of age and gender. Average EDP is not different for male and female subgroups classified by BB. However, EDVI is significantly (P<.002) smaller for women among these groups. When comparing EDP+ and their control we observe that in both groups EDE is about 14% (P<.0001) higher in women compared to men. CONCLUSIONS Due to their smaller EDVI, EDE is higher in women, regardless of BB. Also, EDE increases with age, but only for patients adherent to BB. These findings have implications for the interpretation of diastolic dysfunction in HF, especially for older female patients with BB.