Sex-Associated Differences in Cardiac Reverse Remodeling in Patients Supported by Contemporary Left Ventricular Assist Devices
Autor: | David T. Majure, Mark Hofmeyer, Nana Afari-Armah, Ezequiel J. Molina, Maria E. Rodrigo, Samer S. Najjar, Farooq H. Sheikh, Steven W. Boyce, Benjamin B. Kenigsberg, Zuyue Wang, Selma F. Mohammed |
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Rok vydání: | 2020 |
Předmět: |
Body surface area
medicine.medical_specialty Ejection fraction business.industry Hemodynamics 030204 cardiovascular system & hematology Device type medicine.disease 03 medical and health sciences 0302 clinical medicine Heart failure Internal medicine Cardiology Etiology Medicine In patient 030212 general & internal medicine Cardiology and Cardiovascular Medicine business Reverse remodeling |
Zdroj: | Journal of Cardiac Failure. 26:494-504 |
ISSN: | 1071-9164 |
Popis: | Background Women differ from men in their left ventricular (LV) structure, function and remodeling with age and diseases. The LV assist device (LVAD) unloads the LV and reversely remodels the heart. We sought to define the effects of sex on longitudinal reverse remodeling after LVAD implantation. Methods and Results Cardiac structure and function were assessed by serial echocardiograms. Mixed effect regression models were constructed to assess the independent contribution of sex to longitudinal changes in cardiac structure and function. A total of 355 consecutive patients with advanced heart failure received continuous flow LVADs between 2006 and 2016. The average age was 56 ± 13 years, 73% were men, and 67% were black. Early (within 3 months) after LVAD implantation, women had a greater reduction in LV dimensions and a greater increase in LV ejection fraction compared with men. These differences were independent of age, body surface area, device type, or ischemic etiology of heart failure. At long-term follow-up, LV dimensions increased slightly over time in women compared with men, but overall, earlier changes were maintained. Conclusion Women had significantly more favorable longitudinal changes in cardiac structure and function in response to LV unloading compared with men. Understanding the cause of sex difference in reverse remodeling after LVAD may help to devise novel therapeutic strategies for women with advanced heart failure. |
Databáze: | OpenAIRE |
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