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Gender differences during mechanical circulatory support.

Evgenij Potapov1, Martin Schweiger, Elke Lehmkuhl

  • 1German Heart Institute Berlin, Germany. potapov@dhzb.de

ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|May 29, 2012
PubMed
Summary
This summary is machine-generated.

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Imbalances in Cardiac Output01:26

Imbalances in Cardiac Output

The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...

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Gender impacts heart failure diagnoses and outcomes in patients with ventricular assist devices (VADs). While survival rates are similar in younger patients, adult women show higher mortality risks on VAD support.

Area of Science:

  • Cardiology and Cardiac Surgery
  • Mechanical Circulatory Support
  • Heart Failure Research

Background:

  • Mechanical circulatory support (MCS) using ventricular assist devices (VADs) is a viable option for end-stage heart failure (HF).
  • Emerging evidence suggests sex-based differences in HF development, prognosis, and cardiac surgery outcomes.
  • Understanding gender distribution and its impact on VAD outcomes is crucial for personalized patient care.

Purpose of the Study:

  • To analyze gender distribution in a large cohort of patients receiving VADs.
  • To investigate the effect of gender on heart failure etiology and outcomes in different age groups.
  • To determine if gender influences procedural success and long-term survival following VAD implantation.

Main Methods:

  • Retrospective analysis of 1,456 patients who underwent VAD implantation.

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  • Patients categorized into three age groups: <13 years, 13-50 years, and >50 years.
  • Analysis of 5-year survival, heart failure etiology, and procedural success (30-day and 5-year survival).

    • Main Results:

    • Equal gender distribution in pediatric patients (<13 years) with no significant survival differences.
    • Adult women (13-50 and >50 years) were underrepresented and exhibited significantly higher 5-year mortality rates on VAD support.
    • Dilated cardiomyopathy was a common HF etiology in younger adults, more frequent in males; ischemic cardiomyopathy predominated in older males.

    Conclusions:

    • Gender significantly impacts HF diagnosis distribution in adult VAD recipients.
    • Women face a higher mortality risk when supported by VADs in adult age groups.
    • Further research is needed to elucidate the mechanisms behind these gender-based outcome disparities in VAD therapy.