Sex Differences in Echocardiographic Measures of Right Ventricular Function and RV-PA Coupling

Area of Science:

• Cardiology
• Cardiopulmonary Physiology
• Echocardiography

Background:

• Right-ventricular-pulmonary arterial (RV-PA) coupling is crucial for cardiopulmonary performance, reflecting RV contractility and pulmonary vascular load.
• The tricuspid annular plane systolic excursion-to-pulmonary artery systolic pressure (TAPSE/sPAP) ratio offers a noninvasive estimate of RV-PA coupling.
• Existing research has not fully clarified sex-related differences in the relationship between RV-PA coupling and pulmonary pressure.

Purpose of the Study:

• To investigate sex-specific variations in pulmonary pressure, diastolic load, and RV systolic function.
• To evaluate potential sex-related differences in RV-PA coupling using echocardiographic parameters.
• To explore the interaction between sex and pulmonary pressure on RV function and coupling.

Main Methods:

• Retrospective analysis of echocardiographic data from 243 adult patients.
• Assessment of pulmonary pressure (sPAP, mPAP, dPAP), diastolic load (E/e', PCWP), and RV systolic function (TAPSE, RV S').
• Estimation of RV-PA coupling via TAPSE/sPAP and RV S'/sPAP ratios; statistical analysis using Fisher's exact test, correlation, and regression.

Main Results:

• Females showed a higher prevalence of abnormal systolic pulmonary artery pressure (sPAP) and E/e' ratio.
• Males had a higher prevalence of abnormal mean pulmonary artery pressure (mPAP) and pulmonary capillary wedge pressure (PCWP).
• Abnormal RV S' velocity was more frequent in females, with inverse correlations between RV function parameters and pulmonary pressure (ρ ≈ -0.45 to -0.55, p < 0.001).

Conclusions:

• Significant sex-related differences were identified in pulmonary pressure indices and RV systolic function parameters.
• No statistically significant difference was observed in the primary RV-PA coupling index between sexes.
• Findings are associative and warrant further investigation to generate hypotheses regarding sex-specific RV-PA interactions.