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Sex Differences in Arterial Stiffness and Left Ventricular Pressure Energetics.

Abstract

Hughes, W.E., Spartano, NL., Lefferts, WK., Augustine, JA., Heffernan, KS. Syracuse University, Syracuse, NY

Purpose: Arterial stiffness and pressure from wave reflections (WR) each negatively alter left ventricular (LV) energetics. There are sex differences in arterial stiffness and WR, which may lead to disproportionate increases in afterload and myocardial work in women. The purpose of this study was to examine sex differences in arterial stiffness, pressure from WR and measures of LV energetics. Methods: 79 apparently healthy adults from the surrounding University community participated in this study, from which 46 were selected (23 females, 23 males) and matched for potential confounders of central hemodynamic burden: age, BMI, brachial blood pressure, and heart rate. Aortic pressure waves, derived from the radial artery using a generalized transfer function, were used to obtain: pulse wave velocity as a measure of aortic stiffness, augmentation index (AIx) and reflection index (RIx) as measures of WR, the subendocardial viability ratio (SEVR) as a measure of myocardial work, and left ventricular pressure effort (∆Ew) as a measure of the energy used by the LV to overcome WR. Results: Analysis of variance revealed women exhibited higher ∆Ew (pConclusion: After controlling for important central hemodynamic confounders, women had higher values of LV effort than men. Results suggest that sex differences in LV energetics are more likely due to increased pressure from WR in women and not sex-differences in arterial stiffness. Although women had increased LV effort, myocardial work was not affected.

Table 1: Subject characteristics (n=46); mean±SE

Measure

Male

Female

Interaction

Age (years)

28±3

29±3

0.77

BMI (kg/m2)

24±0.5

23±0.9

0.32

Systolic Blood Pressure (mm Hg)

119±1

116±1

0.2

Diastolic Blood Pressure (mm Hg)

72±1

74±1

0.06

Heart Rate (bpm)

66±2

62±2

0.11

Augmentation Index (%)

-4±2

12±2

<0.001

Pulse-wave Velocity (m/s)

6.8±0.2

6.2±0.2

<0.05

Wave Reflection Index (%)

41±2

56±3

<0.001

Subendocardial Viability Ratio

179±8

186±10

0.59

∆Ew (dynes s/cm2)

10±151

1033±172

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