Volume 41, Issue 12 pp. 1529-1536
CLINICAL INVESTIGATIONS
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Sex-related differences in left ventricular diastolic function and arterial elastance during admission in patients with heart failure with preserved ejection fraction: The PURSUIT HFpEF study

Shiro Hoshida

Corresponding Author

Shiro Hoshida

Department of Cardiovascular Medicine, Yao Municipal Hospital, Osaka, Japan

Correspondence

Shiro Hoshida, MD, PhD, Department of Cardiovascular Medicine, Yao Municipal Hospital, 1-3-1 Ryuge-cho, Yao, Osaka 581-0069, Japan.

Email: [email protected]

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Tetsuya Watanabe

Tetsuya Watanabe

Department of Cardiovascular Medicine, Yao Municipal Hospital, Osaka, Japan

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Yukinori Shinoda

Yukinori Shinoda

Department of Cardiovascular Medicine, Yao Municipal Hospital, Osaka, Japan

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Kuniyasu Ikeoka

Kuniyasu Ikeoka

Department of Cardiovascular Medicine, Yao Municipal Hospital, Osaka, Japan

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Tomoko Minamisaka

Tomoko Minamisaka

Department of Cardiovascular Medicine, Yao Municipal Hospital, Osaka, Japan

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Hidetada Fukuoka

Hidetada Fukuoka

Department of Cardiovascular Medicine, Yao Municipal Hospital, Osaka, Japan

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Hirooki Inui

Hirooki Inui

Department of Cardiovascular Medicine, Yao Municipal Hospital, Osaka, Japan

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Keisuke Ueno

Keisuke Ueno

Department of Cardiovascular Medicine, Yao Municipal Hospital, Osaka, Japan

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Shinichiro Suna

Shinichiro Suna

Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka, Japan

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Daisaku Nakatani

Daisaku Nakatani

Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka, Japan

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Shungo Hikoso

Shungo Hikoso

Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka, Japan

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Takahisa Yamada

Takahisa Yamada

Division of Cardiology, Osaka General Medical Center, Osaka, Japan

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Yoshio Yasumura

Yoshio Yasumura

Department of Cardiology, Amagasaki Chuo Hospital, Hyogo, Japan

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Hisakazu Fuji

Hisakazu Fuji

Cardiovascular Division, Kobe Ekisaikai Hospital, Hyogo, Japan

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Yasushi Sakata

Yasushi Sakata

Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka, Japan

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on behalf of PURSUIT HFpEF Investigators

on behalf of PURSUIT HFpEF Investigators

The complete list of investigators has been provided in the Supporting information Appendix S1.Search for more papers by this author
First published: 17 September 2018
Citations: 20

Abstract

Background

We previously reported that an index of afterload-related left ventricular diastolic function, operant diastolic elastance (Ed)/effective arterial elastance (Ea) = E/e’/(0.9 × systolic blood pressure), was significantly higher in elderly hypertensive women. We aimed to determine sex-related differences in the E/e’-related indices for left ventricular diastolic function and their related factors during admission in patients with heart failure with preserved ejection fraction (HFpEF).

Hypothesis

Elderly HFpEF women exhibit severe left ventricular diastolic dysfunction associated with different left atrioventricular volume ratio.

Methods

We divided 267 patients with HFpEF (men/women, 116/151) into two groups by age (≥75 years, n = 212; <75 years, n = 55). We examined the alterations of E/e’, E/e’/stroke volume index = Ed, and Ed/Ea, and cardiac structure during admission.

Results

Ed and Ea were significantly higher in women than in men, at admission, especially in patients ≥75 years. Before discharge, not only Ed and Ea but also Ed/Ea was significantly higher in women than in men, especially in patients ≥75 years. Elderly female patients had larger left atrial than left ventricular volume.

Conclusions

Higher afterload-related left ventricular diastolic elastance, Ed/Ea, in association with higher arterial elastance, Ea, accompanied by left atrioventricular volume mismatch was observed in elderly HFpEF women.

CONFLICTS OF INTEREST

The authors declare no potential conflict of interests.

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