Gender Difference in the Association between Aortic Pulse Pressure and Left Ventricular Filling Pressure in the Elderly: An Invasive Hemodynamic Study

J Card Fail. 2017 Mar;23(3):224-230. doi: 10.1016/j.cardfail.2017.01.001. Epub 2017 Jan 10.

Abstract

Background: This study was conducted to determine the association between aortic pulse pressure (APP) and left ventricular (LV) filling pressure in the elderly of both genders.

Methods: A total of 211 stable elderly subjects (age ≥65 years, mean age 72.1 ± 5.2 years, 53.6% women) who underwent invasive coronary angiography (ICA) for the evaluation of coronary artery disease (CAD) were prospectively investigated. APP was measured in the ascending aorta using a pigtail catheter immediately before ICA. E/e', reflecting LV filling pressure, was assessed by transthoracic echocardiography.

Results: There were positive linear correlations between APP and E/e' in both genders, but the correlation power was stronger in women than in men (r = 0.402, P <.001 vs r = 0.208, P = .040). The significance of this association between APP and E/e' remained after controlling for potential confounders in multiple linear regression analysis in women (β = 0.359, P <.001), but not in men (r = 0.139, P = .108).

Conclusions: Invasively measured APP is independently associated with E/e' in elderly women, but not in elderly men undergoing ICA. Aortic stiffness may be a potential mechanism for more prevalent LV diastolic dysfunction and heart failure with preserved ejection fraction in elderly women.

Keywords: Aortic pulse pressure; diastolic function; gender difference; heart failure with preserved ejection fraction.

MeSH terms

  • Aged
  • Aorta, Thoracic / diagnostic imaging
  • Aorta, Thoracic / physiopathology*
  • Arterial Pressure / physiology*
  • Cardiac Catheterization
  • Echocardiography, Doppler, Color
  • Female
  • Follow-Up Studies
  • Heart Failure / diagnosis
  • Heart Failure / epidemiology
  • Heart Failure / physiopathology*
  • Heart Ventricles / diagnostic imaging
  • Heart Ventricles / physiopathology*
  • Humans
  • Male
  • Prevalence
  • Prospective Studies
  • Republic of Korea / epidemiology
  • Sex Factors
  • Stroke Volume / physiology
  • Ventricular Function, Left / physiology*
  • Ventricular Pressure / physiology*