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Sex differences in echocardiographic parameters in patients with Acute Myocardial Infarction and Preserved Ejection Fraction.
Session:
Sessão de Posters 50 - Doença coronária - diferenças demográficas
Speaker:
Oliver Correia Kungel
Congress:
CPC 2024
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
13. Acute Coronary Syndromes
Subtheme:
13.7 Acute Coronary Syndromes - Other
Session Type:
Cartazes
FP Number:
---
Authors:
Oliver Correia Kungel; Vanda Devesa Neto; António Costa; Inês Pires; Joana Correia; Gonçalo Ferreira; João Gouveia Fiuza; Mariana Duarte Almeida; Francisco Rodrigues Dos Santos
Abstract
<p style="text-align:justify"><em><strong>Background: </strong></em>Heart failure with preserved ejection fraction (HFpEF) is more common in women compared to men. Women tend to develop HFpEF at an older age and are more likely to have comorbid conditions such as hypertension, diabetes mellitus, and obesity, which are significant contributors to HFpEF. Although, historically, ischemic heart disease has been more prevalent in men. </p> <p style="text-align:justify">The aim of this study is to determine the interaction between sex and echocardiographic parameters in patients admitted due to Acute Myocardial Infarction (AMI) with HFpEF and correlate the findings with 12 months-mortality (12MM). </p> <p style="text-align:justify"> </p> <p style="text-align:justify"><strong><em>Methods:</em></strong> A retrospective analysis of 276 patients admitted to a Cardiology ward diagnosed with AMI and with left ventricle ejection fraction (LVEF) > 50% by transthoracic echocardiogram (TTE) during hospital stay. The primary endpoint was defined as 12MM. Mann-Whitney U and Chi-square test were used for mean comparison between variables. Baseline echocardiographic data were compared between males and females, and cox multivariate regression analysis was performed to elucidate the effect of sex, echocardiographic measures and baseline characteristics. </p> <p style="text-align:justify"> </p> <p><em><strong>Results: </strong></em>Mean patient age was 63.0 (±13.6) years; 79% were male. No differences were found between sex regarding the presence of obesity (p=0.49), type 2 diabetes mellitus (p=0.152), arterial hypertension (p=0.51), dyslipidemia (p=0.51), smoking habits (p=0.12), chronic kidney disease (p=0.72) and chronic pulmonary disease (p=0.27). </p> <p>Higher Global Longitudinal Strain (GLS) (p=0.04) and Mitral Annular Plane Systolic Excursion (MAPSE) (p<0.01) were found in males and higher E/E’ ratio (p<0.01) was found in females. No differences were found regarding other TTE parameters such as left ventricular ejection fraction (LVEF), tricuspid annular plane systolic excursion, E/A ratio, wall motion score index and left atrium volume. </p> <p>No differences were found between sex regarding 12 months-mortality (p=0.11). </p> <p>Cox regression analysis revealed that E/E’ was an independent predictor of 12 months-mortality, even when adjusted to GLS (p=0.022; HR 1.19; 95% CI 1.03-1.38). <br /> ROC curve analysis demonstrated that E/E’ effectively predicts 12 months mortality in women (AUC 0.833) but, in men, the performance is less effective (AUC 0.644). </p> <p><br /> <em><strong>Conclusions:</strong></em> GLS, E/E’ ratio and MAPSE are significantly different in males and females. The increase in E/E’ ratio is associated with a higher risk of 12MM in women, which is independent from the effect of other clinical and echocardiographic variables.</p>
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