Heart failure & cardiomyopathies
Sex Differences in Age-Associated Concentric Remodeling and Diastolic Dysfunction
Authors' conclusion
The age-associated cardiac remodeling and reduced diastolic function in older females were independent of comorbidities, supporting intrinsic sex-specific differences in cardiac aging emerging after the menopausal transition. These findings support the development of precise, sex-specific prevention strategies.
Study context
- Population
- Individuals with echocardiographic assessment of left ventricular geometric remodeling and diastolic functionfemales/males: 18,476/23,601, sensitivity subgroup free of comorbidities N = 14,250
- Participants
- 42,077 individuals
- Exposure
- Age-associated differences in echocardiographic parameters between sexes
- Femalesn = 18,476
- Malesn = 23,601
- Outcome
- Age-by-sex interaction for all key parameters
Methodological detailscovariate-adjusted general linear models, sensitivity analysis on a subgroup free of comorbidities
- Covariate-adjusted general linear models
- Sensitivity analysis on a subgroup free of comorbidities
Main finding
As reported in the abstract
- Significant age-by-sex interactions for all key parameters with covariate adjustment
- P < 0.001
Observational data: associations, not effects.
Further findings
Relative wall thickness · after age 60
- Marked rise in relative wall thickness in females after age 60 (interaction F)
- F = 18.88
- Females demonstrated increased age-related interventricular septal thickening and left ventricular end-diastolic diameter decline, indicating a shift toward concentric remodeling
E' velocity and E/e' ratio · from the sixth decade
- E' velocity decreased significantly and E/e' ratio increased significantly in females from the sixth decade
- F = 26.32
Left atrial volume index and tricuspid regurgitation pressure gradient
- Older females exhibited larger left atrial volume index and higher tricuspid regurgitation pressure gradients
Composite z-score of diastolic function parameters · sixth decade
- Significant sex-specific disparities, sixth decade as the age of marked divergence in diastolic function
- F = 36.86
Sensitivity analysis in individuals without comorbidities
- These patterns persisted in the subanalysis of individuals without comorbidities
- Subgroup N = 14,250
Original publication
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