Gender differences in right ventricular function in patients with non-ischaemic cardiomyopathy

Area of Science:

• Cardiology
• Cardiovascular Imaging
• Heart Failure Research

Background:

• Dilated cardiomyopathy (DCM) affects the heart's main pumping chambers.
• Sex-based differences in cardiovascular disease presentation and progression are increasingly recognized.
• Right ventricular (RV) function is a critical determinant of outcomes in DCM.

Purpose of the Study:

• To investigate potential sex-related differences in RV function using cardiac magnetic resonance imaging (CMR).
• To assess RV function in patients with stable non-ischaemic DCM.
• To correlate RV function with the severity of left ventricular (LV) systolic dysfunction in a sex-specific manner.

Main Methods:

• Prospective, multicentre study involving 71 DCM patients and 14 healthy controls.
• Cardiac magnetic resonance imaging (CMR) was utilized for comprehensive RV function assessment.
• Patient data included demographics, clinical parameters, and LV and RV systolic function metrics.

Main Results:

• Men exhibited higher hemoglobin and white blood cell counts and better cardiopulmonary stress test performance compared to women.
• In patients with severe LV systolic dysfunction, mean RV ejection fraction (RVEF) was significantly lower in men (39%) than in women (52%) (p=0.035).
• Severe RV systolic dysfunction (RVEF < 35%) was observed in 50% of men versus 8% of women with severe LV dysfunction (p<0.001).

Conclusions:

• RV systolic dysfunction in DCM is predominantly identified in male patients, particularly those with severe LV systolic dysfunction.
• Women with severe LV dysfunction demonstrated preserved RV systolic function.
• These findings highlight significant sex-based disparities in RV involvement in non-ischaemic dilated cardiomyopathy.