2016


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2016/№3

Left ventricular diastolic dysfunction in patients with IHD: Gender peculiarities

Sumin A. N.1, Korok E. V.1, Arkhipov O. G.2
1 – Federal State Budgetary Institution, “Research Institute for Complex Issues of Cardiovascular Diseases” at the Siberian Branch of the Russian Academy of Medical Sciences, Sosnovy Bulvar 6, Kemerovo 650002
2 – Federal Budgetary Institution, Rehabilitation Center “Topaz” of the RF Social Insurance Fund, Leskhoznaya 1, Myski 652840, Kemerovo Region

Keywords: gender peculiarities, diastolic dysfunction of the left ventricle, ischaemic heart disease

DOI: 10.18087/rhfj.2016.3.2229

Background. In recent years, effects of gender peculiarities on detection rate, clinical manifestations, and prediction of CHF have been extensively studied. Aim. To study gender peculiarities in indexes of LV diastolic function in patients with IHD. Materials and methods. The study included 718 patients with IHD who were evaluated at the Federal Budgetary Institution, Rehabilitation Center “Topaz” of the RF Social Insurance Fund. Based on gender and presence of LV diastolic dysfunction (DD), 4 groups of patients were formed: group 1 – women without LV DD (n=157; age 62 [56; 67]); group 2 – women with LV DD (n=130; age 63 [57; 70]); group 3 – men without LV DD (n=226; age 60 [54; 66]); and group 4 – men with LV DD (n=205; age 61 [56; 68]). EchoCG study was performed for all patients. Results. According to calculations, LV DD was observed in 47.7 % of male patients and 45.3 % of female patients (р=0.529). Although no significant intergroup differences were found for any LV DD pattern, the impaired relaxation pattern was observed more frequently than other patterns (29.4 and 30.3 %, respectively; р=0.793). Thus, isovolumic relaxation time (IVRT) was significantly increased in the presence of LV DD in both men and women (р<0.001). Mean LV early diastolic filling velocity (E) was higher in women without LV DD (71 cm/sec; р=0,007) whereas the LV late diastolic filling velocity (А) was the lowest in men without LV DD (66 cm/sec; р=0.002). Furthermore, the Е / А ratio was the lowest in women with LV DD (0.8; р=0.002) and the early diastolic mitral flow propagation velocity (EDMFPV) – in patients of both sexes with LV DD (р<0.001). According to results of logistic regression analysis the predictors influencing development of LV DD were age (р=0.008), smoking (р<0.001), presence of clinical signs of angina (р<0.001), AH (р=0.034), and reduced LV EF (р<0.001) in men and reduced LV EF (р=0.001) in women. Conclusion. Gender-related differences in features and prevalence of DD patterns were not observed. Among patients without signs of LV DD, male patients had lower than female patients LV early diastolic filling velocity and longer LV isovolumic relaxation time (p<0.05), which indicated impaired LV filling. Reduced LV EF was the factor associated with the presence of LV DD in both men and women (p<0.001 for both); in men, additional factors were age, smoking, AH, and angina.
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Sumin A. N., Korok E. V., Arkhipov O. G. Left ventricular diastolic dysfunction in patients with IHD: Gender peculiarities. Russian Heart Failure Journal. 2016;17 (3):164–172

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