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Related Experiment Videos

Gender differences in left ventricular function at rest and with exercise in asymptomatic aortic stenosis

M E Legget1, J Kuusisto, N L Healy

  • 1Department of Medicine, University of Washington, Seattle 98195-6422, USA.

American Heart Journal
|January 1, 1996
PubMed
Summary

Gender influences left ventricular response to aortic stenosis. Women exhibit smaller, hypercontractile hearts and reduced exercise capacity compared to men, highlighting the importance of considering sex in cardiovascular disease management.

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Area of Science:

  • Cardiology
  • Cardiovascular Physiology
  • Echocardiography

Background:

  • Asymptomatic aortic stenosis presents unique challenges in understanding gender-specific physiological responses.
  • Previous research has not fully elucidated the differences in left ventricular geometry and function between men and women with this condition.

Purpose of the Study:

  • To investigate gender-based differences in left ventricular (LV) geometry, systolic and diastolic function, functional status, and exercise capacity in patients with asymptomatic aortic stenosis.
  • To determine how these differences impact the heart's response to exercise-induced stress.

Main Methods:

  • Two-dimensional (2-D) and Doppler echocardiography were performed at rest and post-exercise in 29 women and 53 men with asymptomatic aortic stenosis.
  • Measurements included LV volumes, mass, relative wall thickness, fractional shortening, transmitral velocities, and exercise duration.

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  • Functional aerobic impairment and cardiac output changes were assessed.

    • Main Results:

    • Aortic stenosis severity was similar between genders.
    • Women had smaller LV end-diastolic and end-systolic volumes, and lower LV mass, but higher relative wall thickness and fractional shortening.
    • Women reported more functional impairment, had a different diastolic filling profile, shorter exercise duration, greater functional aerobic impairment, and a smaller increase in cardiac output during exercise.

    Conclusions:

    • Women with asymptomatic aortic stenosis exhibit distinct left ventricular characteristics, including smaller, hypercontractile ventricles and altered diastolic function, compared to men.
    • These differences contribute to greater exercise limitation and poorer functional capacity in women.
    • The findings underscore the critical role of gender in the left ventricular adaptation to chronic pressure overload and emphasize the need for gender-specific considerations in managing aortic stenosis.