Background: Advanced heart failure studies demonstrate that ischemic factors increase in prevalence with age and are more prominent in men. Ejection fraction (EF) cannot be preserved in these patients, and ischemic cardiomyopathy develops. Non-ischemic factors are more prominent in female heart failure patients, where the EF is preserved. Although an age-associated increase in the rate of heart failure is acknowledged in both sexes, etiologic classifications by sex-based age groups are still lacking. This study examined the etiology of heart failure according to age and sex in ventricular assist device patients.
Methods: The patient population included 457 end-stage heart failure patients who received a continuous flow-left ventricular assist device at Ege University Hospital between 2010 and 2017. Age, sex, and cardiomyopathy etiology data were obtained from the hospital database. The Mann-Whitney U test was applied to test the statistical significance among subgroups (95% CI, P < .05 for statistical significance).
Results: The prevalence of ischemic cardiomyopathy was significantly lower in male patients aged 18 to 39 years compared to older patients. Conversely, no difference was seen among female patients. The prevalence of dilated cardiomyopathy was higher in male patients who were 18 to 39 years of age compared to older patients, but no difference was present among the female patients.
Conclusions: Age and heart failure etiology were demonstrated to be interrelated in men but not in women. The fact that etiologic factors of advanced heart failure in women have a wider range than in men makes the current classification systems insufficient for use in female populations.
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