Piecing together the puzzle of sex‐specific differences in left ventricular ejection fraction

Olsen, Flemming Javier; Solomon, Scott D.

doi:10.1002/ejhf.2127

Cited by 1 publication

(1 citation statement)

References 19 publications

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“… 33 A supranormal LVEF may also reflect a hyperdynamic state or different patient characteristics, such as anemia, hyperthyroidism, or valvular regurgitations. 35 A hyperdynamic state in women may predispose them to a cardiac vulnerability and increased metabolic demand in high‐stress and overload states, such as HF. In addition, microvascular dysfunction and an increased sympathetic tone, typical adverse features in HFpEF, have also been associated with a supranormal LVEF in women, but not in men.…”

Section: Discussionmentioning

confidence: 99%

Sex‐Related Differences in Mortality Following Admission for Acute Heart Failure Across the Left Ventricular Ejection Fraction Spectrum

Santas

Palau

Llàcer

et al. 2022

JAHA

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Background Following a heart failure (HF)‐decompensation, there is scarce data about sex‐related prognostic differences across left ventricular ejection fraction (LVEF) status. We sought to evaluate sex‐related differences in 6‐month mortality risk across LVEF following admission for acute HF. Methods and Results We retrospectively evaluated 4812 patients consecutively admitted for acute HF in a multicenter registry from 3 hospitals. Study end points were all‐cause, cardiovascular, and HF‐related mortality at 6‐month follow‐up. Multivariable Cox regression models were fitted to investigate sex‐related differences across LVEF. A total of 2243 (46.6%) patients were women, 2569 (53.4%) were men, and 2608 (54.2%) showed LVEF≥50%. At 6‐month follow‐up, 645 patients died (13.4%), being 544 (11.3%) and 416 (8.6%) cardiovascular and HF‐related deaths, respectively. LVEF was not independently associated with mortality (HR, 1.02; 95% CI 0.99–1.05; P =0.135). After multivariable adjustment, we found no sex‐related differences in all‐cause mortality ( P value for interaction=0.168). However, a significant interaction between sex and cardiovascular and HF mortality risks was found across LVEF ( P value for interaction=0.030 and 0.007, respectively). Compared with men, women had a significantly lower risk of cardiovascular and HF‐mortality at LVEF<25% and <43%, respectively. On the contrary, women showed a higher risk of HF‐mortality at the upper extreme of LVEF (>80%). Conclusions Following an admission for acute HF, no sex‐related differences were found in all‐cause mortality risk. However, when compared with men, women showed a lower risk of cardiovascular and HF‐mortality at the lower extreme of LVEF. On the contrary, they showed a higher risk of HF death at the upper extreme.

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Section: Discussionmentioning

confidence: 99%

Sex‐Related Differences in Mortality Following Admission for Acute Heart Failure Across the Left Ventricular Ejection Fraction Spectrum

Santas

Palau

Llàcer

et al. 2022

JAHA

View full text Add to dashboard Cite

show abstract

Piecing together the puzzle of sex‐specific differences in left ventricular ejection fraction

Abstract: This article refers to 'Ejection fraction and mortality: a nationwide register-based cohort study of 499 153 women and men' by S. Stewart et al., published in this issue on pages 406-416.

Cited by 1 publication

References 19 publications

Sex‐Related Differences in Mortality Following Admission for Acute Heart Failure Across the Left Ventricular Ejection Fraction Spectrum

Sex‐Related Differences in Mortality Following Admission for Acute Heart Failure Across the Left Ventricular Ejection Fraction Spectrum

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