Luchner, Andreas and Broeckel, Ulrich and Muscholl, Michael and Hense, Hans-Werner and Doring, Angela and Riegger, Guenter A. J. and Schunkert, Heribert (2002) Gender-specific differences of cardiac remodeling in subjects with left ventricular dysfunction: a population-based study. CARDIOVASCULAR RESEARCH, 53 (3): PII S0008-. pp. 720-727. ISSN 0008-6363, 1755-3245
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Background: Recent studies suggest that female gender is associated with a lower prevalence and a more benign prognosis of heart failure. In the current population-based study, it was our objective to evaluate the implications of gender on the association between impaired left ventricular (LV) function and mass as well as neurohumoral activation. Methods and results: A total of 1883 subjects (992 female, 891 male) of two MONICA surveys in Augsburg, Germany, were analyzed. Participants of one of these surveys were additionally characterized with respect to neurohormonal activation. As compared to men, women were characterized by a slightly higher LV ejection fraction (EF, Teichholz-Method, 65.4 +/- 0.3%, vs. 63.4 +/- 0.3, P < 0.01) and a markedly lower LV mass index (LVMI 81 +/- 1 g/m(2) vs. 96 +/- 1, P < 0.01). As compared to men with normal LV function, those with LV dysfunction (EF below mean minus two standard deviations, S.D.) were characterized by significantly increased LV mass (LVMI +48%, P < 0.01), plasma BNP (+373%, P < 0.01) and ANP (+57%, P < 0.01), while no significant changes were observed in women (LVMI +3%, BNP +48%, ANP +27%, all P = n.s). Only a small subgroup of women with severe LVD (EF below mean - 3 S.D.) was characterized by significantly increased LV mass (LVMI +23%, P < 0.05 vs. control and LVD), however, this increase was less pronounced as compared to men with severe LVD (LVMI +46%, P < 0.01 vs. control). Gender-specific differences between LV function and structure were also confirmed by multivariate analysis. While LVMI was independently and significantly correlated with EF in male subjects in addition to systolic blood pressure, age, and body mass index (all P < 0.01), these parameter, displaced EF as a predictor of LVMI in female subjects. Conclusions: Men with moderate or severe LV dysfunction are characterized by an increase in both LV mass and cardiac natriuretic peptide plasma concentrations. In contrast, LV mass and natriuretic peptide concentration,-, increase to a lesser extent and only with severe LV dysfunction in women. These observational data suggest gender-specific control of myocardial adaptations to hemodynamic overload and a more rapid induction of LV hypertrophy during myocardial dysfunction in male subjects. (C) 2002 Elsevier Science B.V. All rights reserved.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | CONGESTIVE-HEART-FAILURE; NATRIURETIC PEPTIDES; ESSENTIAL-HYPERTENSION; SEX-DIFFERENCES; HYPERTROPHY; ADAPTATION; SURVIVAL; DISEASE; HORMONE; CARE; epidemiology; gender; hypertrophy; hypertension; heart failure; natriuretic peptide; ultrasound |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 09 Nov 2021 09:46 |
| Last Modified: | 09 Nov 2021 09:46 |
| URI: | https://pred.uni-regensburg.de/id/eprint/40591 |
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