Preserved ejection fraction and structural heart disease in 446 848 patients investigated with echocardiography
Abstract Background Sex‐specific differences in left ventricular ejection fraction (LVEF) and responses to neurohormonal modulating therapies are relevant to clinical trials of treatment for heart failure with preserved ejection fraction (HFpEF). Aims This study aimed to identify the proportion and...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-04-01
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| Series: | ESC Heart Failure |
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| Online Access: | https://doi.org/10.1002/ehf2.13149 |
| _version_ | 1818618632996913152 |
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| author | David Playford Geoffrey Strange Simon Stewart NEDA Investigators |
| author_facet | David Playford Geoffrey Strange Simon Stewart NEDA Investigators |
| author_sort | David Playford |
| collection | DOAJ |
| description | Abstract Background Sex‐specific differences in left ventricular ejection fraction (LVEF) and responses to neurohormonal modulating therapies are relevant to clinical trials of treatment for heart failure with preserved ejection fraction (HFpEF). Aims This study aimed to identify the proportion and characteristics of patients presenting with possible or confirmed HFpEF within the National Echo Database of Australia. Results A total of 237 046 women (48.1%) and 256 019 men (aged 61.0 ± 18.3 vs. 60.6 ± 17.1 years, respectively) had sex‐specific distributions of LVEF: 94.3% of women had LVEF ≥ 45% (mean LVEF 66.0 ± 8.6%), compared with 87.2% of men (mean LVEF 63.4 ± 8.7%). The presence of structural heart disease (SHD) according to the PARAGON‐HF criteria could be calculated in 93.8% of women and 93.4% of men with an LVEF ≥ 45%. Of these, 64 502 (30.8%) women and 104 344 (50.0%) of men had left ventricular hypertrophy, and 78 948 (35.3%) and 95 846 (42.9%), respectively, had left atrial enlargement. As a result, the proportion of women vs. men fulfilling echocardiographic criteria for HFpEF was very different: 111 497 (53.2%) vs. 146 359 (70.1%). SHD markedly increased with age, associated with a greater increase in women than men. The same signal was observed in those referred for suspected or previously confirmed HFpEF. Conclusions Double the number of men than women had LVEF < 45%, and the distribution of SHD had was highly sex specific. Left ventricular hypertrophy and left atrial enlargement were more common in men and becoming more frequent in women with advancing age. The echocardiographic SHD distribution was similar in those referred with suspected or confirmed HFpEF. The findings are relevant to sex‐specific recruitment criteria for future clinical trials. |
| first_indexed | 2024-12-16T17:24:41Z |
| format | Article |
| id | doaj.art-6cbffb204aa140879d0cc45901805fee |
| institution | Directory Open Access Journal |
| issn | 2055-5822 |
| language | English |
| last_indexed | 2024-12-16T17:24:41Z |
| publishDate | 2021-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj.art-6cbffb204aa140879d0cc45901805fee2022-12-21T22:23:05ZengWileyESC Heart Failure2055-58222021-04-01821687169010.1002/ehf2.13149Preserved ejection fraction and structural heart disease in 446 848 patients investigated with echocardiographyDavid Playford0Geoffrey Strange1Simon Stewart2NEDA InvestigatorsSchool of Medicine The University of Notre Dame Australia 19 Mouat St Fremantle WA AustraliaSchool of Medicine The University of Notre Dame Australia 19 Mouat St Fremantle WA AustraliaTorrens University Australia Adelaide SA AustraliaAbstract Background Sex‐specific differences in left ventricular ejection fraction (LVEF) and responses to neurohormonal modulating therapies are relevant to clinical trials of treatment for heart failure with preserved ejection fraction (HFpEF). Aims This study aimed to identify the proportion and characteristics of patients presenting with possible or confirmed HFpEF within the National Echo Database of Australia. Results A total of 237 046 women (48.1%) and 256 019 men (aged 61.0 ± 18.3 vs. 60.6 ± 17.1 years, respectively) had sex‐specific distributions of LVEF: 94.3% of women had LVEF ≥ 45% (mean LVEF 66.0 ± 8.6%), compared with 87.2% of men (mean LVEF 63.4 ± 8.7%). The presence of structural heart disease (SHD) according to the PARAGON‐HF criteria could be calculated in 93.8% of women and 93.4% of men with an LVEF ≥ 45%. Of these, 64 502 (30.8%) women and 104 344 (50.0%) of men had left ventricular hypertrophy, and 78 948 (35.3%) and 95 846 (42.9%), respectively, had left atrial enlargement. As a result, the proportion of women vs. men fulfilling echocardiographic criteria for HFpEF was very different: 111 497 (53.2%) vs. 146 359 (70.1%). SHD markedly increased with age, associated with a greater increase in women than men. The same signal was observed in those referred for suspected or previously confirmed HFpEF. Conclusions Double the number of men than women had LVEF < 45%, and the distribution of SHD had was highly sex specific. Left ventricular hypertrophy and left atrial enlargement were more common in men and becoming more frequent in women with advancing age. The echocardiographic SHD distribution was similar in those referred with suspected or confirmed HFpEF. The findings are relevant to sex‐specific recruitment criteria for future clinical trials.https://doi.org/10.1002/ehf2.13149EchocardiographySystolic functionEjection fractionStructural heart diseaseSex‐specific |
| spellingShingle | David Playford Geoffrey Strange Simon Stewart NEDA Investigators Preserved ejection fraction and structural heart disease in 446 848 patients investigated with echocardiography ESC Heart Failure Echocardiography Systolic function Ejection fraction Structural heart disease Sex‐specific |
| title | Preserved ejection fraction and structural heart disease in 446 848 patients investigated with echocardiography |
| title_full | Preserved ejection fraction and structural heart disease in 446 848 patients investigated with echocardiography |
| title_fullStr | Preserved ejection fraction and structural heart disease in 446 848 patients investigated with echocardiography |
| title_full_unstemmed | Preserved ejection fraction and structural heart disease in 446 848 patients investigated with echocardiography |
| title_short | Preserved ejection fraction and structural heart disease in 446 848 patients investigated with echocardiography |
| title_sort | preserved ejection fraction and structural heart disease in 446 848 patients investigated with echocardiography |
| topic | Echocardiography Systolic function Ejection fraction Structural heart disease Sex‐specific |
| url | https://doi.org/10.1002/ehf2.13149 |
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