Sex Differences in the Evaluation of Congestion Markers in Patients with Acute Heart Failure
The impact of sex on the assessment of congestion in acute heart failure (AHF) is still a matter of debate. The objective of this analysis was to evaluate sex differences in the evaluation of congestion at admission in patients hospitalized for AHF. We consecutively enrolled 494 AHF patients (252 fe...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-02-01
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| Series: | Journal of Cardiovascular Development and Disease |
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| Online Access: | https://www.mdpi.com/2308-3425/9/3/67 |
| _version_ | 1797470628774674432 |
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| author | Pietro Scicchitano Claudio Paolillo Micaela De Palo Angela Potenza Silvia Abruzzese Marco Basile Antonia Cannito Maria Tangorra Piero Guida Pasquale Caldarola Marco Matteo Ciccone Francesco Massari |
| author_facet | Pietro Scicchitano Claudio Paolillo Micaela De Palo Angela Potenza Silvia Abruzzese Marco Basile Antonia Cannito Maria Tangorra Piero Guida Pasquale Caldarola Marco Matteo Ciccone Francesco Massari |
| author_sort | Pietro Scicchitano |
| collection | DOAJ |
| description | The impact of sex on the assessment of congestion in acute heart failure (AHF) is still a matter of debate. The objective of this analysis was to evaluate sex differences in the evaluation of congestion at admission in patients hospitalized for AHF. We consecutively enrolled 494 AHF patients (252 female). Clinical congestion assessment, B-type natriuretic peptide levels analysis, blood urea nitrogen to creatinine ratio (BUN/Cr), plasma volume status estimate (by means of Duarte or Kaplam-Hakim PVS), and hydration status evaluation through bioimpedance analysis were performed. There was no difference in medications between men and women. Women were older (79 ± 9 yrs vs. 77 ± 10 yrs, <i>p</i> = 0.005), and had higher left ventricular ejection fraction (45 ± 11% vs. 38 ± 11%, <i>p</i> < 0.001), and lower creatinine clearance (42 ± 25 mL/min vs. 47 ± 26 mL/min, <i>p</i> = 0.04). The prevalence of peripheral oedema, orthopnoea, and jugular venous distention were not significantly different between women and men. BUN/Cr (27 ± 9 vs. 23 ± 13, <i>p</i> = 0.04) and plasma volume were higher in women than men (Duarte PVS: 6.0 ± 1.5 dL/g vs. 5.1 ± 1.5 dL/g, <i>p</i> < 0.001; Kaplam–Hakim PVS: 7.9 ± 13% vs. −7.3 ± 12%, <i>p</i> < 0.001). At multivariate logistic regression analysis, female sex was independently associated with BUN/Cr and PVS. Female sex was independently associated with subclinical biomarkers of congestion such as BUN/Cr and PVS in patients with AHF. A sex-guided approach to the correct evaluation of patients with AHF might become the cornerstone for the correct management of these patients. |
| first_indexed | 2024-03-09T19:38:54Z |
| format | Article |
| id | doaj.art-af8baf61c61e4f4082d854aa14b81bf6 |
| institution | Directory Open Access Journal |
| issn | 2308-3425 |
| language | English |
| last_indexed | 2024-03-09T19:38:54Z |
| publishDate | 2022-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj.art-af8baf61c61e4f4082d854aa14b81bf62023-11-24T01:45:52ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252022-02-01936710.3390/jcdd9030067Sex Differences in the Evaluation of Congestion Markers in Patients with Acute Heart FailurePietro Scicchitano0Claudio Paolillo1Micaela De Palo2Angela Potenza3Silvia Abruzzese4Marco Basile5Antonia Cannito6Maria Tangorra7Piero Guida8Pasquale Caldarola9Marco Matteo Ciccone10Francesco Massari11Cardiology Section, Hospital “F. Perinei”, 70022 Bari, ItalyCardiology Section, Hospital “Umberto I”, 70033 Bari, ItalyCardiac Surgery Unit, Azienda Ospedaliero-Universitaria Policlinico Bari, 70124 Bari, ItalyCardiology Section, Hospital “F. Perinei”, 70022 Bari, ItalyCardiology Section, Hospital “F. Perinei”, 70022 Bari, ItalyCardiology Section, Hospital “F. Perinei”, 70022 Bari, ItalyCardiology Section, Hospital “F. Perinei”, 70022 Bari, ItalyCardiology Section, Hospital “F. Perinei”, 70022 Bari, ItalyCardiology Section, Hospital “Miulli”, Acquaviva delle Fonti, 70021 Bari, ItalyCardiology Section, S. Paolo Hospital, 70132 Bari, ItalySection of Cardiovascular Diseases, Department of Emergency and Organ Transplantation, University of Bari, 70124 Bari, ItalyCardiology Section, Hospital “F. Perinei”, 70022 Bari, ItalyThe impact of sex on the assessment of congestion in acute heart failure (AHF) is still a matter of debate. The objective of this analysis was to evaluate sex differences in the evaluation of congestion at admission in patients hospitalized for AHF. We consecutively enrolled 494 AHF patients (252 female). Clinical congestion assessment, B-type natriuretic peptide levels analysis, blood urea nitrogen to creatinine ratio (BUN/Cr), plasma volume status estimate (by means of Duarte or Kaplam-Hakim PVS), and hydration status evaluation through bioimpedance analysis were performed. There was no difference in medications between men and women. Women were older (79 ± 9 yrs vs. 77 ± 10 yrs, <i>p</i> = 0.005), and had higher left ventricular ejection fraction (45 ± 11% vs. 38 ± 11%, <i>p</i> < 0.001), and lower creatinine clearance (42 ± 25 mL/min vs. 47 ± 26 mL/min, <i>p</i> = 0.04). The prevalence of peripheral oedema, orthopnoea, and jugular venous distention were not significantly different between women and men. BUN/Cr (27 ± 9 vs. 23 ± 13, <i>p</i> = 0.04) and plasma volume were higher in women than men (Duarte PVS: 6.0 ± 1.5 dL/g vs. 5.1 ± 1.5 dL/g, <i>p</i> < 0.001; Kaplam–Hakim PVS: 7.9 ± 13% vs. −7.3 ± 12%, <i>p</i> < 0.001). At multivariate logistic regression analysis, female sex was independently associated with BUN/Cr and PVS. Female sex was independently associated with subclinical biomarkers of congestion such as BUN/Cr and PVS in patients with AHF. A sex-guided approach to the correct evaluation of patients with AHF might become the cornerstone for the correct management of these patients.https://www.mdpi.com/2308-3425/9/3/67sexcongestionacute heart failureplasma volume statusBUN/Cr ratio |
| spellingShingle | Pietro Scicchitano Claudio Paolillo Micaela De Palo Angela Potenza Silvia Abruzzese Marco Basile Antonia Cannito Maria Tangorra Piero Guida Pasquale Caldarola Marco Matteo Ciccone Francesco Massari Sex Differences in the Evaluation of Congestion Markers in Patients with Acute Heart Failure Journal of Cardiovascular Development and Disease sex congestion acute heart failure plasma volume status BUN/Cr ratio |
| title | Sex Differences in the Evaluation of Congestion Markers in Patients with Acute Heart Failure |
| title_full | Sex Differences in the Evaluation of Congestion Markers in Patients with Acute Heart Failure |
| title_fullStr | Sex Differences in the Evaluation of Congestion Markers in Patients with Acute Heart Failure |
| title_full_unstemmed | Sex Differences in the Evaluation of Congestion Markers in Patients with Acute Heart Failure |
| title_short | Sex Differences in the Evaluation of Congestion Markers in Patients with Acute Heart Failure |
| title_sort | sex differences in the evaluation of congestion markers in patients with acute heart failure |
| topic | sex congestion acute heart failure plasma volume status BUN/Cr ratio |
| url | https://www.mdpi.com/2308-3425/9/3/67 |
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