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Sex Differences in Diastolic Function Following Myocardial Infarction on Doppler Echocardiography.

Nicole Ivy Chan1, John J Atherton1,2, Liza Thomas3

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Female sex is a significant predictor of diastolic dysfunction after myocardial infarction, even with preserved ejection fraction. This finding helps explain higher heart failure rates in women post-MI.

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Area of Science:

  • Cardiology
  • Echocardiography
  • Sex Differences in Cardiovascular Disease

Background:

  • Females exhibit preserved left ventricular ejection fraction (LVEF) post-myocardial infarction (MI) but higher heart failure rates.
  • Diastolic dysfunction (DD) is presumed to be the cause of increased heart failure in females post-MI.

Purpose of the Study:

  • To investigate sex-based differences in left ventricular diastolic function using Doppler echocardiography following MI.
  • To determine if female sex is an independent predictor of diastolic dysfunction after a first-ever MI.

Main Methods:

  • Analysis of 2505 patients with first-ever MI (2013-2020), with echocardiography within 24 hours of admission.
  • Definition of significant DD (grade 2-3) and calculation of Diastolic Function Score (DFS) based on four key parameters.
  • Multivariable models used to identify independent predictors of diastolic parameters, including sex.

Main Results:

  • Females were older, had more comorbidities, but higher LVEF compared to males.
  • Females showed greater abnormalities in left atrial volume index (LAVI), e' velocity, E/e' ratio, significant DD, and DFS.
  • Female sex independently predicted abnormal LAVI, E/e' ratio, tricuspid regurgitation velocity (TRV), significant DD, and DFS.

Conclusions:

  • Female sex is a strong independent predictor of diastolic dysfunction on Doppler echocardiography in patients post-MI.
  • These findings may elucidate the higher incidence of heart failure in females despite preserved LVEF after MI.