Maternal cardiovascular hemodynamics in a patient with mitral prosthetic heart valve evaluated with impedance cardiography and echocardiography

The female human heart at rest and during exercise: A review

“…This lower resting HR in active men, coupled with a similar normalised cardiac output between the sexes regardless of training status (Carlsson et al, 2012; Yilmaz et al, 2013), suggests that they may also have a greater relative SV. Yet mixed results for relative SV with the use of different ratiometric scaling approaches, such as fat‐free mass (Ogawa et al, 1992) and body surface area (Yilmaz et al, 2013) exist, highlighting the need for further investigations before conclusions can be drawn.…”

“…Previous authors have reported larger resting cardiac output in males (Lynn et al, 2007), whilst others maintain a lack of sexual dimorphism regarding this variable (Sandstede et al, 2000;Sullivan, Cobb, & Higginbotham, 1991;Yilmaz, Buyukakilli, Gurgul, & Rencuzogullari, 2013). Indexing cardiac output to body surface area has resulted in values that are mostly similar between the sexes (Carlsson et al, 2012;Hossack & Bruce, 1982;Sandstede et al, 2000;Sullivan et al, 1991;Yilmaz et al, 2013). Adult women, however, appear to have a higher resting ejection fraction (EF) than agematched men (Cain et al, 2009;Hanley et al, 1989;Fleg et al, 1995;Kaku et al, 2011;Sandstede et al, 2000), even after controlling for HR, body surface area, body mass index or fat-free mass (Bella et al, 2006;Celentano et al, 2003).…”

“…With a lack of consensus regarding differences in resting SV and HR between men and women, it is not surprising that cardiac output data are also conflicting. Previous authors have reported larger resting cardiac output in males (Lynn et al, 2007), whilst others maintain a lack of sexual dimorphism regarding this variable (Sandstede et al, 2000;Sullivan, Cobb, & Higginbotham, 1991;Yilmaz, Buyukakilli, Gurgul, & Rencuzogullari, 2013). Indexing cardiac output to body surface area has resulted in values that are mostly similar between the sexes (Carlsson et al, 2012;Hossack & Bruce, 1982;Sandstede et al, 2000;Sullivan et al, 1991;Yilmaz et al, 2013).…”

“…In addition to the influence of body size on cardiac comparisons between men and women, age and training status clearly affect cardiac structure and function. Increasing age is associated with a lower cardiac mass and reduction in function (Kaku et al, 2011), and exercise trained men and women have a lower resting HR and greater LV mass than their less active counterparts (Carlsson et al, 2012; Yilmaz et al, 2013). The impact of both of these variables on the heart is further complicated by potential interactions with the female sex hormones.…”

“…Women, however, have faster peak lengthening rates of the LV (Grandi et al, 1992), a higher early‐to‐late (E/A) transmitral filling velocity ratio (Daimon et al, 2011) and faster early diastolic myocardial velocities (E′; Figure 1; Daimon et al, 2011; Okura et al, 2009), all suggestive of a superior diastology in comparison to men. In contrast, men have a faster late diastolic myocardial velocity (A′), which may reflect a greater atrial contribution in order to achieve optimal LV filling (Wilhelm et al, 2011; Yilmaz et al, 2013). Accordingly, it appears that women have a greater reliance on LV relaxation during early diastole, but men depend on LV compliance and atrial contraction during late diastole to maintain EDV.…”