Sex-Associated Differences in Cardiac Reverse Remodeling in Patients Supported by Contemporary Left Ventricular Assist Devices.
Sex-Associated Differences in Cardiac Reverse Remodeling in Patients Supported by Contemporary Left Ventricular Assist Devices.
- 2020
Available online from MWHC library: 1995 - present
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. 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 devise novel therapeutic strategies for women with advanced HF. Copyright (c) 2020. Published by Elsevier Inc. METHODS: 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. RESULTS: A total of 355 consecutive patients with advanced heart failure (HF) 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, BSA, device type or ischemic etiology of HF. At long-term follow-up, LV dimensions increased slightly over time in women compared with men, but overall earlier changes were maintained.
English
1071-9164
10.1016/j.cardfail.2020.03.005 [doi] S1071-9164(19)31402-2 [pii]
*Heart Failure
*Heart-Assist Devices
Female
Heart Failure/dg [Diagnostic Imaging]
Heart Failure/th [Therapy]
Hemodynamics
Humans
Male
Middle Aged
Sex Characteristics
Ventricular Function, Left
Ventricular Remodeling
MedStar Heart & Vascular Institute
Journal Article
Available online from MWHC library: 1995 - present
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. 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 devise novel therapeutic strategies for women with advanced HF. Copyright (c) 2020. Published by Elsevier Inc. METHODS: 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. RESULTS: A total of 355 consecutive patients with advanced heart failure (HF) 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, BSA, device type or ischemic etiology of HF. At long-term follow-up, LV dimensions increased slightly over time in women compared with men, but overall earlier changes were maintained.
English
1071-9164
10.1016/j.cardfail.2020.03.005 [doi] S1071-9164(19)31402-2 [pii]
*Heart Failure
*Heart-Assist Devices
Female
Heart Failure/dg [Diagnostic Imaging]
Heart Failure/th [Therapy]
Hemodynamics
Humans
Male
Middle Aged
Sex Characteristics
Ventricular Function, Left
Ventricular Remodeling
MedStar Heart & Vascular Institute
Journal Article