Sex-dependent differences in left ventricular function and structure in chronic pressure overload

Détails

ID Serval
serval:BIB_0018D1CC3042
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Sex-dependent differences in left ventricular function and structure in chronic pressure overload
Périodique
European Heart Journal
Auteur(s)
Villari  B., Campbell  S. E., Schneider  J., Vassalli  G., Chiariello  M., Hess  O. M.
ISSN
0195-668X (Print)
Statut éditorial
Publié
Date de publication
10/1995
Volume
16
Numéro
10
Pages
1410-9
Notes
Journal Article --- Old month value: Oct
Résumé
To evaluate gender-related differences in left ventricular (LV) structure and function in aortic stenosis, LV biplane cineangiography, micromanometry and endomyocardial biopsies were carried out in 56 patients with aortic stenosis and normal coronary arteries. Patients were divided into males (M: n = 35), and females (F: n = 21). Sixteen normal subjects 8 M, 8 F) served as haemodynamic controls. Control biopsy data were obtained from six pre-transplantation donor hearts (3 M and 3 F). LV systolic function was evaluated by ejection fraction and its relationship to mean systolic circumferential wall stress, diastolic function by the time constant of LV pressure decay, peak filling rates and passive myocardial stiffness constant. Biopsy samples were evaluated for interstitial fibrosis, muscle fibre diameter and volume fraction of myofibrils. In a subset of 27 consecutive patients, biopsy samples were evaluated with a morphometric-morphological method, for total collagen volume fraction, endocardial fibrosis and the extension and thickness of orthogonal collagen fibres (cross-hatching). In patients with aortic stenosis, aortic valve area, aortic valve resistance and mean aortic pressure gradient were comparable in males and females, whereas end-systolic and end-diastolic volumes were larger in males than females. Ejection fraction was lower (56%) in males than females (64%) (P < 0.05); 20 of 35 males and four of 21 females had depressed systolic contractility when assessed with regard to the relationship ejection fraction-mean systolic stress (P < 0.01). Myocardial stiffness constant was higher in males than in females (P < 0.01). Nine of 14 males and two of 13 females had endocardial fibrosis (P < 0.009), whereas increased cross-hatching (> 1.5 grade) was present in 11 males and four females with aortic stenosis (P < 0.01). An abnormal collagen architecture was present in 13/14 males and 5/13 females (P < 0.002). In aortic stenosis, males have a depressed systolic function and abnormal passive elastic properties when compared to females with valve lesions of similar severity. Changes in collagen architecture may account, at least in part, for these differences.
Mots-clé
Adolescent Adult Aged Aortic Valve Stenosis/pathology/*physiopathology Blood Pressure/*physiology Cineangiography Collagen/physiology Diastole/physiology Endocardium/*pathology Endomyocardial Fibrosis/pathology/physiopathology Female Humans Hypertrophy, Left Ventricular/pathology/*physiopathology Male Middle Aged Myocardial Contraction/physiology Myocardium/*pathology Sex Factors Stroke Volume/physiology Systole/physiology Ventricular Function, Left/*physiology
Pubmed
Web of science
Création de la notice
28/01/2008 11:32
Dernière modification de la notice
20/08/2019 13:22
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