Department of Cardiology, Medical University of Lodz, 91-347 Lodz, Poland.
Menopause. 2010 May-Jun;17(3):560-5. doi: 10.1097/gme.0b013e3181c4ef85.
Our aim was to evaluate the impact of gender on the diastolic function of the left ventricle in healthy men and women and in patients with coronary artery disease (CAD) without systolic impairment.
We examined 67 healthy participants (34 men with a mean age of 51 +/- 13 y and ejection fraction [EF] of 62% +/- 3% and 33 women with a mean age of 53 +/- 11 y and EF of 63% +/- 3%; P = NS) and 60 patients with CAD (36 men with a mean age of 57 +/- 10 y and EF of 59% +/- 3% and 24 women with a mean age of 59 +/- 10 y and EF of 60% +/- 3%), paired with regard to age, heart rate, and medical treatment by transthoracic echocardiography with the assessment of mitral and pulmonary vein flow parameters, propagation of mitral filling waves, and tissue Doppler variables of mitral annulus motion (MAM). The impact of gender was assessed separately for the healthy participants and the CAD group.
In healthy participants, the velocity of mitral inflow early wave and the systolic velocity of the pulmonary vein flow were significantly higher in women than in men: 77 +/- 18 versus 65 +/- 19 cm/second (P < 0.05) and 64 +/- 14 versus 57 +/- 11 cm/second (P < 0.05), respectively. On the other hand, velocities of MAM in the atrial and systolic phases were higher in men than in women: 13 +/- 2 versus 12 +/- 2 cm/second and 11 +/- 2 versus 10 +/- 2 cm/second, respectively (P < 0.05). The opposite tendency was observed in the CAD group: the ratio of early mitral inflow velocity to atrial mitral inflow velocity was significantly higher in male patients (1.1 +/- 0.5 vs 0.8 +/- 0.2; P = 0.007) and there was a trend toward faster early wave propagation in men (40 +/- 9 vs 36 +/- 8 cm/s; P = 0.08).
Our data suggest more efficient early diastolic filling in postmenopausal women than in age-matched men in healthy participants but an opposite relationship in patients with CAD.
本研究旨在评估性别对左心室舒张功能的影响，研究对象为健康男性和女性以及无收缩功能障碍的冠心病（CAD）患者。
我们检查了 67 名健康参与者（34 名男性，平均年龄 51 ± 13 岁，射血分数 [EF]为 62% ± 3%；33 名女性，平均年龄 53 ± 11 岁，EF 为 63% ± 3%；P = NS）和 60 名 CAD 患者（36 名男性，平均年龄 57 ± 10 岁，EF 为 59% ± 3%；24 名女性，平均年龄 59 ± 10 岁，EF 为 60% ± 3%），通过经胸超声心动图评估二尖瓣和肺静脉血流参数、二尖瓣充盈波的传播以及二尖瓣环运动（MAM）的组织多普勒变量，对这些参与者进行了年龄、心率和药物治疗方面的配对。分别评估了健康参与者和 CAD 组中性别对舒张功能的影响。
在健康参与者中，女性的二尖瓣前向血流早期速度和肺静脉收缩期血流速度明显高于男性：77 ± 18 比 65 ± 19 cm/秒（P < 0.05）和 64 ± 14 比 57 ± 11 cm/秒（P < 0.05）。另一方面，男性的 MAM 心房和收缩期速度高于女性：13 ± 2 比 12 ± 2 cm/秒和 11 ± 2 比 10 ± 2 cm/秒（P < 0.05）。在 CAD 组中则观察到相反的趋势：男性患者的早期二尖瓣血流速度与心房二尖瓣血流速度的比值明显更高（1.1 ± 0.5 比 0.8 ± 0.2；P = 0.007），并且男性的早期波传播速度也呈上升趋势（40 ± 9 比 36 ± 8 cm/s；P = 0.08）。
我们的数据表明，在健康参与者中，绝经后女性的早期舒张充盈功能比年龄匹配的男性更有效，但在 CAD 患者中则存在相反的关系。
