JACC: Advances (Oct 2024)

Sex-Related Differences in Left Ventricular Geometry Patterns in Patients With Arterial Hypertension

  • Grazia Canciello, PhD,
  • Raffaele Piccolo, MD, PhD,
  • Raffaele Izzo, MD, PhD,
  • Eduardo Bossone, MD, PhD,
  • Daniela Pacella, PhD,
  • Maria Lembo, MD, PhD,
  • Maria Virginia Manzi, MD, PhD,
  • Costantino Mancusi, MD, PhD,
  • Fiorenzo Simonetti, MD,
  • Felice Borrelli, MD,
  • Giuseppe Giugliano, MD,
  • Giovanni Esposito, MD, PhD,
  • Maria-Angela Losi, MD

Journal volume & issue
Vol. 3, no. 10
p. 101256

Abstract

Read online

Background: Sex-specific differences in left ventricular (LV) geometry might help in developing tailored strategies for hypertension management. Objectives: The purpose of the study was to evaluate sex-related differences in LV geometry at baseline and over time in hypertension. Methods: From a prospective registry, we included hypertensives without prevalent cardiovascular disease, incident myocardial infarction, chronic kidney disease > stage III, and with normal LV ejection fraction. LV mass index >115 g/m2 in males and >95 g/m2 in females, identified LV hypertrophy (LVH). Relative wall thickness ≥0.43 defined LV concentric geometry. LVH in presence of concentric geometry was defined as concentric LVH, whereas relative wall thickness <0.43 was categorized as eccentric. Concentric geometry, or LVH, identified LV remodeling. Results: Six thousand four hundred twenty-seven patients (age 53 ± 11 years, 43% females) were included. At baseline, females showed lower prevalence of normal geometric pattern and higher prevalence of LVH than males (50% vs 72%, P < 0.001; 47% vs 23%, P < 0.001, respectively), with a higher prevalence of eccentric LVH (40% vs 18%, P < 0.001). Female sex was independently associated with LV remodeling (OR: 2.36; 95% CI: 2.12-2.62; P < 0.001). At long-term follow-up (mean 6.1 years, IQR: 2.8-8.6 years), prevalence of LV remodeling increased in both sexes, although a normal LV geometry remained less frequent in females than males (43% vs 67%, P < 0.001), with differences persisting in eccentric (41% vs 21%, P < 0.001) and concentric LVH (11% vs 5%, P < 0.001). Conclusions: We found sex-related differences in LV geometry among hypertensives. Females have higher risk of LV remodeling at baseline compared with males, with differences persisting at long-term follow-up.

Keywords