Alberto Aimo1, Giuseppe Vergaro2, Vincenzo Castiglione1, Andrea Barison2, Emilio Pasanisi3, Christina Petersen3, Vladyslav Chubuchny3, Alberto Giannoni3, Roberta Poletti3, Silvia Maffei3, James L Januzzi4, Claudio Passino2, Michele Emdin5. 1. Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy. 2. Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy; Cardiology Division, Fondazione Toscana Gabriele Monasterio, Pisa, Italy. 3. Cardiology Division, Fondazione Toscana Gabriele Monasterio, Pisa, Italy. 4. Cardiology Division, Massachusetts General Hospital and Harvard Clinical Research Institute, Boston, Massachusetts. 5. Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy; Cardiology Division, Fondazione Toscana Gabriele Monasterio, Pisa, Italy. Electronic address: emdin@ftgm.it.
Abstract
OBJECTIVES: This study sought to investigate sex-related differences in reverse remodeling (RR). BACKGROUND: RR, that is, the recovery from left ventricular (LV) dilation and dysfunction in response to treatment for heart failure (HF), is associated with improved prognosis. METHODS: Data from patients with stable systolic HF (LV ejection fraction [LVEF] of <50%) undergoing 2 transthoracic echocardiograms within 12 ± 2 months were analyzed. Reverse remodeling was defined as a ≥15% reduction in LV end-systolic volume index. RESULTS: A total of 927 patients were evaluated (68 ± 12 years; median LVEF = 35% [interquartile range: 30% to 43%]; 27% women). Ischemic HF was less often encountered in women (33% vs. 60%, respectively; p < 0.001), whereas most characteristics did not differ with regard to sex. Women showed a higher incidence of RR (41% vs. 27%, respectively; p < 0.001), despite similar baseline LV volume and function. RR was more frequent among women in the subgroups with either ischemic or nonischemic HF, as well as in all categories of systolic dysfunction (LVEF ≤35% or >35%, according to current indication for device implantation, and LVEF <40% or 40% to 50% according to the definition of HF with reduced or mid-range EF). In the whole population, female sex was an independent predictor of RR (hazard ratio: 1.54; 95% confidence interval: 1.11 to 2.14; p = 0.011), together with cause of HF, disease duration, and left bundle branch block. Female sex was again an independent predictor of RR in all LVEF categories. CONCLUSIONS: Reverse remodeling is more frequent among women, regardless of cause and severity of LV dysfunction. Female sex is an independent predictor of RR in all categories of LV systolic dysfunction.
OBJECTIVES: This study sought to investigate sex-related differences in reverse remodeling (RR). BACKGROUND: RR, that is, the recovery from left ventricular (LV) dilation and dysfunction in response to treatment for heart failure (HF), is associated with improved prognosis. METHODS: Data from patients with stable systolic HF (LV ejection fraction [LVEF] of <50%) undergoing 2 transthoracic echocardiograms within 12 ± 2 months were analyzed. Reverse remodeling was defined as a ≥15% reduction in LV end-systolic volume index. RESULTS: A total of 927 patients were evaluated (68 ± 12 years; median LVEF = 35% [interquartile range: 30% to 43%]; 27% women). Ischemic HF was less often encountered in women (33% vs. 60%, respectively; p < 0.001), whereas most characteristics did not differ with regard to sex. Women showed a higher incidence of RR (41% vs. 27%, respectively; p < 0.001), despite similar baseline LV volume and function. RR was more frequent among women in the subgroups with either ischemic or nonischemic HF, as well as in all categories of systolic dysfunction (LVEF ≤35% or >35%, according to current indication for device implantation, and LVEF <40% or 40% to 50% according to the definition of HF with reduced or mid-range EF). In the whole population, female sex was an independent predictor of RR (hazard ratio: 1.54; 95% confidence interval: 1.11 to 2.14; p = 0.011), together with cause of HF, disease duration, and left bundle branch block. Female sex was again an independent predictor of RR in all LVEF categories. CONCLUSIONS: Reverse remodeling is more frequent among women, regardless of cause and severity of LV dysfunction. Female sex is an independent predictor of RR in all categories of LV systolic dysfunction.
Authors: Manuel Martínez-Sellés; Pablo Díez-Villanueva; Jesús Álvarez Garcia; Andreu Ferrero-Gregori; Miquel Vives-Borrás; Fernando Worner; Alfredo Bardají; Juan F Delgado; Rafael Vázquez; José R González-Juanatey; Francisco Fernández-Aviles; Juan Cinca Journal: Clin Cardiol Date: 2018-07-23 Impact factor: 2.882
Authors: María Dolores García-Cosío; Francisco González-Vilchez; Raquel López-Vilella; Eduardo Barge-Caballero; Manuel Gómez Bueno; Manuel Martínez-Selles; Jose María Arizón; Diego Rangel Sousa; José González-Costello; Sonia Mirabet; Félix Pérez-Villa; Beatriz Díaz Molina; Gregorio Rábago; Ana Portolés Ocampo; Luis de la Fuente Galán; Iris Garrido; Juan F Delgado Journal: Front Cardiovasc Med Date: 2021-02-25
Authors: Nasrien E Ibrahim; Ileana L Piña; Alexander Camacho; Devavrat Bapat; G Michael Felker; Alan S Maisel; Javed Butler; Margaret F Prescott; Cheryl A Abbas; Scott D Solomon; James L Januzzi Journal: Eur J Heart Fail Date: 2020-10-07 Impact factor: 15.534