A Deeper Look into Heart Failure: The Role of Age, Gender, and Menopause
A compelling study casts a spotlight on the intersection of age, gender, and heart failure. The research centered on heart failure with preserved ejection fraction (HFpEF), a specific type of heart failure more prevalent as individuals age and more common in females. The findings highlight potential gender differences in cardiac characteristics and hint at a crucial role of menopause in these disparities.
What is HFpEF?
Heart failure with preserved ejection fraction, commonly referred to as HFpEF, is a form of heart failure where the heart's main pumping chamber, the left ventricle, retains its pumping power, but is stiff or thickened. This condition restricts the heart from filling with blood properly, causing the body to receive less blood than it needs.
The Research Overview
This intriguing study included a carefully selected group of 634 patients in sinus rhythm with preserved ejection fractions greater than 50%. The group also had to meet several other health criteria, such as normal chamber sizes, no more than mild valvular dysfunction, and a tricuspid regurgitation gradient under 39 mmHg.
Two analytical statistical tests, the Kruskal-Wallis and Mann-Whitney U tests, were used to unravel the complexity of the data. The research aimed to compare the echocardiographic parameters of the left ventricle between genders across age deciles, i.e., every ten years of age.
Discovering Gender Differences
It was found that, among the 65% of females in the group, the ejection fraction, or the amount of blood pumped out with each heartbeat, was slightly larger than males in the same age group, starting from the fifties decade. This difference became more pronounced as the age increased.
Certain heart failure characteristics, like mitral inflow changes, indicated that HFpEF's tell-tale signs progressively emerged with advancing age. Yet, no distinct gender differences were observed in these echocardiographic changes.
An intriguing revelation was that, while body surface area was normalized, the left ventricle's diastolic diameters decreased in both males and females, but systolic diameter and left atrial size changes were exclusive to females. Specifically, the left ventricular systolic diameter decreased and left atrial size increased in women, changes that were not evident in men.
Heart Failure, Hormones, and a Potential Link to Menopause
This sequential evolution of heart failure characteristics, coupled with the left ventricle structural changes, highlights potential physiological differences between men and women. The larger ejection fraction in women, starting from their fifties, and the unique structural changes suggest that the loss of sex hormones, a hallmark of menopause, may influence the pathophysiology of HFpEF.
George, K., et. al. 2023. Heart Lung and Circulation. 32(3): S157.
In essence, the study opens the door for a better understanding of HFpEF, illustrating how gender and age intricately interact with the disease's progress. The research invites further investigation into the potential role of menopause and sex hormones in the etiology of HFpEF, offering hope for future tailored therapeutic approaches for heart failure. This once again illustrates just how important hormone health and balance is as we age. Jason & Rita...aka Dr. De Leon and Dr. Gillespie.
