The influence of sex on left ventricular remodeling in patients with aortic dissection

Author:

Diniz Roberto G.S.1,Oliveira Matheus F.R.A.2,Rocha Walter E.M.2,Cipolli José A.2,Soares Julia D.1,L’Armée Victor M.F.S.1,Martins Mayara P.G.3,Rocha Aloísio M.3,Diniz Paulo G.S.1,Feitosa Audes D.M.14,Lima Ricardo C.1,Oliveira Pedro P.M.5,Silveira-Filho Lindemberg M.5,Coelho-Filho Otavio R.2,Matos-Souza José R.2,Petrucci Orlando5,Sposito Andrei C.2,Nadruz Wilson2

Affiliation:

1. Pernambuco Cardiology Emergency Room (PROCAPE), University of Pernambuco, Recife, PE

2. Department of Internal Medicine, School of Medical Sciences, State University of Campinas, São Paulo

3. Department of Cardiology, Pontifical Catholic University of Campinas, Campinas, SP

4. UNICAP Institute of Clinical Research, Catholic University of Pernambuco, Recife, PE

5. Department of Surgery, School of Medical Sciences, State University of Campinas, São Paulo, Brazil

Abstract

Aims Patients with aortic dissection have a high prevalence of left ventricular structural alterations, including left ventricular hypertrophy (LVH), but little is known about the impact of sex on this regard. This study compared clinical, cardiac, and prognostic characteristics between men and women with aortic dissection. Methods We retrospectively assessed clinical and echocardiographic characteristics, and 1-year mortality in 367 aortic dissection patients (30% women; 66% with Stanford-A) who underwent echocardiography 60 days before or after the diagnosis of aortic dissection from three Brazilian centers. Results Men and women had similar clinical characteristics, except for higher age (59.4 ± 13.4 vs. 55.9 ± 11.6 years; P = 0.013) and use of antihypertensive classes (1.4 ± 1.3 vs. 1.1 ± 1.2; P = 0.024) and diuretics (32 vs. 19%; P = 0.004) in women compared with men. Women had a higher prevalence of LVH (78 vs. 65%; P = 0.010) and lower prevalence of normal left ventricular geometry (20 vs. 10%; P = 0.015) than men. Logistic regression analysis adjusted for confounding factors showed that women were less likely to have normal left ventricular geometry (odds ratio, 95% confidence interval = 0.42, 0.20–0.87; P = 0.019) and were more likely to have LVH (odds ratio, 95% confidence interval = 1.91, 1.11–3.27; P = 0.019). Conversely, multivariable Cox-regression analysis showed that women had a similar risk of death compared to men 1 year after aortic dissection diagnosis (hazard ratio, 95% confidence interval = 1.16, 0.77–1.75; P = 0.49). Conclusion In aortic dissection patients, women were typically older, had higher use of antihypertensive medications, and exhibited a greater prevalence of LVH compared with men. However, 1-year mortality after aortic dissection diagnosis did not differ between men and women.

Publisher

Ovid Technologies (Wolters Kluwer Health)

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