Biological Sex Differences in the US-CTEPH-R

Area of Science:

• Cardiopulmonary Medicine
• Pulmonary Hypertension Research
• Sex Differences in Disease

Background:

• Biological sex influences cardiopulmonary conditions, with known sex paradoxes in pulmonary arterial hypertension.
• Sex differences in chronic thromboembolic pulmonary hypertension (CTEPH) are less understood compared to pulmonary arterial hypertension (PAH).

Purpose of the Study:

• To investigate and characterize sex differences in patients diagnosed with CTEPH in the United States.
• To explore how biological sex impacts CTEPH presentation, treatment, and outcomes.

Main Methods:

• Utilized data from the multicenter United States CTEPH Registry, collecting data every six months for 48 months.
• Compared male and female characteristics using descriptive analyses and regression modeling, adjusting for age and BMI.
• Performed survival analysis using Cox proportional hazards modeling.

Main Results:

• Females had higher BMI, while males were more likely to have a history of deep vein thrombosis.
• Males demonstrated better baseline PH-specific health-related quality of life (HRQoL), WHO functional class, and six-minute walk distance.
• Males were less likely to have distally located disease or inoperable CTEPH; however, no significant difference in overall survival was observed between sexes.

Conclusions:

• Distinct CTEPH phenotypes exist between males and females, potentially influencing pulmonary thromboendarterectomy (PTE) access and feasibility.
• Sex-associated disparities exist in the disease experience and HRQoL for CTEPH patients.
• Further investigation is warranted to understand differential impacts on HRQoL and disease experience.