Limits...
Right ventricular sex differences in patients with idiopathic pulmonary arterial hypertension characterised by magnetic resonance imaging: pair-matched case controlled study.

Swift AJ, Capener D, Hammerton C, Thomas SM, Elliot C, Condliffe R, Wild JM, Kiely DG - PLoS ONE (2015)

Bottom Line: Men are less frequently affected by the condition but have worse outcome as compared to females.However, there was no significant difference in RV mass or haemodynamic indices of mPAP and PVR between males and females.We hypothesise that adaptive remodelling of the RV in response to increased afterload in IPAH is more effective in females.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiovascular Science, University of Sheffield, Sheffield, United Kingdom; INSIGNEO, Institute for In Silico Medicine, University of Sheffield, Sheffield, United Kingdom.

ABSTRACT

Purpose: Sex differences exist in both the prevalence and survival of patients with idiopathic pulmonary arterial hypertension (IPAH). Men are less frequently affected by the condition but have worse outcome as compared to females. We sought to characterise the sex related differences in right ventricular remodelling in age matched male and female patients with IPAH using cardiac magnetic resonance imaging (MRI).

Methods: A case controlled pair-matched study was conducted with patients matched by age and sex. Steady state free precession (SSFP) MRI of the heart was performed at 1.5T. Cardiac volume, function and mass measurements were corrected for age, sex and BSA according to reference data.

Results: 40 age and sex matched patients with IPAH were identified. The mean age was 57 (SD 17) in both male and female cohorts. Men had proportionally lower right ventricular (RV) ejection fraction, RV stroke volume and LV stroke volume than females, p=0.028, p=0.007 and p=0.013, respectively. However, there was no significant difference in RV mass or haemodynamic indices of mPAP and PVR between males and females.

Conclusion: Male patients with IPAH have proportionally worse RV function despite similar afterload. We hypothesise that adaptive remodelling of the RV in response to increased afterload in IPAH is more effective in females.

No MeSH data available.


Related in: MedlinePlus

Kaplan Meier plot showing the prognostic significance of sex in age matched patients with IPAH.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4440634&req=5

pone.0127415.g002: Kaplan Meier plot showing the prognostic significance of sex in age matched patients with IPAH.

Mentions: There is a large systematic bias between Maceria et al and Kawut et al RV mass data, 34g +/- 9g higher by Maceria data. Estimated RV mass in our population for age, gender and BSA (Maceria) and height and weight (Kawut) correlate well (r = 0.917 p<0.0001). Only moderate agreement was identified at intraclass correlation coefficient analysis, 0.740 (CI 0.596 to 0.833). Estimated RV end diastolic volume for age, sex and BSA by Maceria and Kawut data show a strong correlation (r = 0.964, p<0.0001), and good agreement, intraclass correlation coefficient 0.981 (0.971 to 0.988). Estimated RV end-diastolic volume measured by Maceria et al data was 15ml +/- 9ml higher than by Kawut data. Right ventricular measurements had a good inter-observer reproducibility, with the intraclass correlation coefficient measuring 0.900–0.967. At Cox proportional hazards regression analysis male patients had significantly worse outcome than females Hazard Ratio 2.30 (1.05–5.08; p = 0.039), in addition males have higher mortality at Kaplan Meier analysis, p = 0.033, see Fig 2.


Right ventricular sex differences in patients with idiopathic pulmonary arterial hypertension characterised by magnetic resonance imaging: pair-matched case controlled study.

Swift AJ, Capener D, Hammerton C, Thomas SM, Elliot C, Condliffe R, Wild JM, Kiely DG - PLoS ONE (2015)

Kaplan Meier plot showing the prognostic significance of sex in age matched patients with IPAH.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4440634&req=5

pone.0127415.g002: Kaplan Meier plot showing the prognostic significance of sex in age matched patients with IPAH.
Mentions: There is a large systematic bias between Maceria et al and Kawut et al RV mass data, 34g +/- 9g higher by Maceria data. Estimated RV mass in our population for age, gender and BSA (Maceria) and height and weight (Kawut) correlate well (r = 0.917 p<0.0001). Only moderate agreement was identified at intraclass correlation coefficient analysis, 0.740 (CI 0.596 to 0.833). Estimated RV end diastolic volume for age, sex and BSA by Maceria and Kawut data show a strong correlation (r = 0.964, p<0.0001), and good agreement, intraclass correlation coefficient 0.981 (0.971 to 0.988). Estimated RV end-diastolic volume measured by Maceria et al data was 15ml +/- 9ml higher than by Kawut data. Right ventricular measurements had a good inter-observer reproducibility, with the intraclass correlation coefficient measuring 0.900–0.967. At Cox proportional hazards regression analysis male patients had significantly worse outcome than females Hazard Ratio 2.30 (1.05–5.08; p = 0.039), in addition males have higher mortality at Kaplan Meier analysis, p = 0.033, see Fig 2.

Bottom Line: Men are less frequently affected by the condition but have worse outcome as compared to females.However, there was no significant difference in RV mass or haemodynamic indices of mPAP and PVR between males and females.We hypothesise that adaptive remodelling of the RV in response to increased afterload in IPAH is more effective in females.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiovascular Science, University of Sheffield, Sheffield, United Kingdom; INSIGNEO, Institute for In Silico Medicine, University of Sheffield, Sheffield, United Kingdom.

ABSTRACT

Purpose: Sex differences exist in both the prevalence and survival of patients with idiopathic pulmonary arterial hypertension (IPAH). Men are less frequently affected by the condition but have worse outcome as compared to females. We sought to characterise the sex related differences in right ventricular remodelling in age matched male and female patients with IPAH using cardiac magnetic resonance imaging (MRI).

Methods: A case controlled pair-matched study was conducted with patients matched by age and sex. Steady state free precession (SSFP) MRI of the heart was performed at 1.5T. Cardiac volume, function and mass measurements were corrected for age, sex and BSA according to reference data.

Results: 40 age and sex matched patients with IPAH were identified. The mean age was 57 (SD 17) in both male and female cohorts. Men had proportionally lower right ventricular (RV) ejection fraction, RV stroke volume and LV stroke volume than females, p=0.028, p=0.007 and p=0.013, respectively. However, there was no significant difference in RV mass or haemodynamic indices of mPAP and PVR between males and females.

Conclusion: Male patients with IPAH have proportionally worse RV function despite similar afterload. We hypothesise that adaptive remodelling of the RV in response to increased afterload in IPAH is more effective in females.

No MeSH data available.


Related in: MedlinePlus