Gender Variations in the Clinical and Phenotypic Presentation of Right- Sided Heart Failure The right-side heart failure in women
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Abstract
Right heart failure (RHF) is a complex syndrome and carries a worse prognosis. The studies are limited in identifying gender differences in clinical and imaging findings of RHF. Method: a retrospective review of patients presenting with RHF. Results: 966 patients were reviewed; women accounted for 570 (59%) of patients with RHF. The mean age was 57±16 years. The most common co-morbidity included diabetes 419 (43%), class II obesity 323 (33.5%), and atrial fibrillation 409 (42%). The heart failure with preserved ejection fraction (HFpEF) was the dominant phenotype 601 (62%). Women had more HFpEF 415 (72.8%), while men had more HF with reduced EF (HFrEF) 207 (52.5%). The mean left ventricle (LV) dimension was 5.2±0.8 cm, and the mean right ventricle (RV) dimensions were 4.2±0.8 cm. Men had more RV dilation than women with an RV end-diastolic dimension of 4.4±0.8 cm, while in women, 4.1±0.8 with a p-value <0.0001. The mean tricuspid annular plane systolic excursion (TAPSE) was 1.4±0.5 cm, and the RV lateral wall s’ was 9±3. Men had more RV dysfunction, with TAPSE being 1.3±0.6 cm, while in women, it was 1.5±0.5 cm with a p-value of 0.002. The s’ of the lateral wall in men was 8.4±3 cm/s, while in women, it was 9.7±3.5 cm/s with a p-value of 0.004. Severe tricuspid valve (TV) regurgitation was more common in women 238 (41.7%). The TV intervention was equal for both genders. Conclusion: Women tend to have more HFpEF and a higher grade of TV regurgitation than men. However, men had more RV dilatation and dysfunction. Prospective studies will add to the understanding of the survival outcomes for men and women with RHF.
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