Sex-specific predictors of left ventricular diastolic dysfunction in untreated hypertension
Authors Jaroch J, Vriz O, BociÄ ga Z, Driussi C, Ćoboz-Rudnicka M, Rzyczkowska B, Ćoboz-GrudzieĆ K
Received 4 June 2016
Accepted for publication 12 August 2016
Published 25 October 2016 Volume 2016:11 Pages 1495—1504
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Lucy Goodman
Peer reviewer comments 3
Editor who approved publication: Dr Richard Walker
Joanna Jaroch,1 Olga Vriz,2 Zbigniew BociÄ
ga,1 Caterina Driussi,2 Maria Ćoboz-Rudnicka,1 Barbara Rzyczkowska,1 Krystyna Ćoboz-GrudzieĆ1,3
1Department of Cardiology, T Marciniak Hospital, Wroclaw, Poland; 2Division of Cardiology, San Antonio Hospital, San Daniele del Friuli, Udine, Italy; 3Health Science Faculty, Wroclaw Medical University, Wroclaw, Poland
Background: Little is known about the sex-specific differences in left ventricular (LV) diastolic dysfunction (DD) predictors. We hypothesized that arterial stiffness (AS) may play a different role in the etiology of LV DD in hypertensive men and postmenopausal women, acting independently from other established predictors of this condition, such as age, obesity, diabetes mellitus, LV remodeling, and systolic function.
Objectives: The aim of the study was to analyze the sex-specific differences in AS and other predictors of LV DD in men and postmenopausal women with untreated hypertension (HTN).
Patients and methods: The study included 144 patients (63 postmenopausal women and 81 men, mean age 62.7±6.7 years) with previously untreated HTN and no history of cardiovascular diseases. All patients were subjected to detailed echocardiography, vascular ultrasound, and high-resolution echotracking (eTracking) of carotid arteries.
Results: In the multivariate analysis, concomitant diabetes mellitus turned out to be an independent predictor of LV DD in women (P=0.02). In turn, two independent predictors of LV DD have been identified in men: S'-tissue Doppler-derived peak LV longitudinal systolic shortening velocity (P=0.001) and β, beta stiffness index (P=0.004).
Conclusion: There are sex differences in the predictors of LV DD in untreated HTN. In postmenopausal women, LV DD is mostly determined by diabetes, while in men, it is determined by S', reflecting LV systolic longitudinal function, and β, a parameter of AS.
Keywords: sex differences, left ventricular diastolic dysfunction, hypertension