Department of Cardiology, Heart Centre Brandenburg Bernau, Faculty of Health Sciences Brandenburg, Brandenburg Medical School (MHB) Theodor Fontane, 16321 Bernau, Germany.
Institute of Social Medicine & Health Care Systems Research, Otto von Guericke University Magdeburg, 39120 Magdeburg, Germany.
Nutrients. 2022 Jan 2;14(1):203. doi: 10.3390/nu14010203.
Men and women with valvular heart disease have different risk profiles for clinical endpoints. Non-esterified fatty acids (NEFA) are possibly involved in cardio-metabolic disease. However, it is unclear whether NEFA concentrations are associated with physical performance in patients undergoing transcatheter aortic valve implantation (TAVI) and whether there are sex-specific effects.
To test the hypothesis that NEFA concentration is associated with sex-specific physical performance, we prospectively analysed data from one hundred adult patients undergoing TAVI. NEFA concentrations, physical performance and anthropometric parameters were measured before and 6 and 12 months after TAVI. Physical performance was determined by a six-minute walking test (6-MWT) and self-reported weekly bicycle riding time.
Before TAVI, NEFA concentrations were higher in patients (44 women, 56 men) compared to the normal population. Median NEFA concentrations at 6 and 12 months after TAVI were within the reference range reported in the normal population in men but not women. Men but not women presented with an increased performance in the 6-MWT over time ( 0.026, 0.142, respectively). Additionally, men showed an increased ability to ride a bicycle after TAVI compared to before TAVI ( 0.034). NEFA concentrations before TAVI correlated with the 6-MWT before TAVI in women (Spearman's rho -0.552; 0.001) but not in men (Spearman's rho -0.007; 0.964). No association was found between NEFA concentrations and physical performance 6 and 12 months after TAVI.
NEFA concentrations improved into the reference range in men but not women after TAVI. Men but not women have an increased physical performance after TAVI. No association between NEFA and physical performance was observed in men and women after TAVI.
患有心脏瓣膜病的男性和女性在临床终点的风险状况不同。非酯化脂肪酸（NEFA）可能与心脏代谢疾病有关。然而，目前尚不清楚 NEFA 浓度是否与行经导管主动脉瓣置换术（TAVI）的患者的身体表现相关，以及是否存在性别特异性影响。
为了检验 NEFA 浓度与性别特异性身体表现相关的假设，我们前瞻性地分析了 100 例接受 TAVI 的成年患者的数据。在 TAVI 前、后 6 个月和 12 个月测量 NEFA 浓度、身体表现和人体测量参数。身体表现通过 6 分钟步行测试（6-MWT）和自我报告的每周骑自行车时间来确定。
在 TAVI 前，与正常人群相比，患者（44 名女性，56 名男性）的 NEFA 浓度更高。TAVI 后 6 个月和 12 个月时的中位 NEFA 浓度处于男性正常人群报告的参考范围内，但女性则不然。与女性相比，男性在 6-MWT 中的表现随时间增加（分别为 0.026，0.142）。此外，与 TAVI 前相比，男性在 TAVI 后骑自行车的能力也有所提高（分别为 0.034）。TAVI 前的 NEFA 浓度与女性的 TAVI 前 6-MWT 相关（Spearman's rho-0.552； 0.001），但与男性无关（Spearman's rho-0.007； 0.964）。TAVI 后 6 个月和 12 个月时，未发现 NEFA 浓度与身体表现之间存在关联。
TAVI 后，男性的 NEFA 浓度改善至参考范围，但女性则不然。TAVI 后，男性的身体表现有所提高。TAVI 后，男性和女性的 NEFA 与身体表现之间没有关联。
