Heart failure & cardiomyopathies
The Oxygen Cascade According to Heart Failure with Preserved Ejection Fraction (HFpEF) Likelihood: A Focus on Sex Differences
Main finding · Peak VO2Result — go to the resultMean difference −4.4 mL/kg/min 95% CI −3.7 to −5.1Authors' conclusion
Women with unexplained dyspnea had significantly lower peak VO2, regardless of HFpEF likelihood, attributed to both lower peak exercise O2 delivery and extraction.
Study context
- Population
- Patients with unexplained dyspnoea undergoing cardiopulmonary exercise testing with simultaneous echocardiography; HFpEF likely if H2FPEF ≥6 or HFA-PEFF ≥5555 high HFpEF likelihood
- Participants
- 1,963 patients
- Exposure
- Women vs men, in high vs low HFpEF likelihood
- Outcome
- Sex differences in peak VO2 and its determinants, by HFpEF likelihood
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
Peak VO2
Mean difference
−4.4 mL/kg/min
95% CI −3.7 to −5.1
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | Estimate |
|---|---|
| O2 delivery and O2 extraction, women vs men · peak exerciseWomen vs Men · O2 delivery | difference −0.5 L/min (95% CI −0.4 to −0.6) |
| O2 delivery and O2 extraction, women vs men · peak exerciseWomen vs Men · oxygen extraction | difference −2.9 mL/dL (95% CI −2.5 to −3.2) |
| Pulmonary haemodynamics, LV structure and function, iron deficiency, women vs menWomen vs Men · mean pulmonary artery pressure/cardiac output slope | difference +0.5 mm Hg/L/min (95% CI 0.3–0.7) |
| Pulmonary haemodynamics, LV structure and function, iron deficiency, women vs menWomen vs Men · LVEF | difference +1 % (95% CI 1%–2%) |
| Pulmonary haemodynamics, LV structure and function, iron deficiency, women vs menWomen vs Men · LV end-diastolic volume | difference −9 mL/m² (95% CI −8 to −11) |
| Pulmonary haemodynamics, LV structure and function, iron deficiency, women vs menWomen vs Men · LV mass | difference −12 g/m² (95% CI −9 to −14) |
- Pulmonary haemodynamics, LV structure and function, iron deficiency, women vs men — Iron deficiency more often in women
- 55% vs 33%; P < 0.001
Causes of reduced O2 delivery in women: hemoglobin and stroke volume
- Lower hemoglobin
- −1.2 g/dL (95% CI: −0.9 to −1.5 g/dL)
- Smaller stroke volume
- −15 mL (95% CI: −14 to −17 mL)
Original publication
The Oxygen Cascade According to HFpEF Likelihood: A Focus on Sex Differences. JACC Adv. Published 11 June 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →