Objective: Our aim was to evaluate the impact of gender on the diastolic function of the left ventricle in healthy men and women and in patients with coronary artery disease (CAD) without systolic impairment.
Methods: We examined 67 healthy participants (34 men with a mean age of 51 +/- 13 y and ejection fraction [EF] of 62% +/- 3% and 33 women with a mean age of 53 +/- 11 y and EF of 63% +/- 3%; P = NS) and 60 patients with CAD (36 men with a mean age of 57 +/- 10 y and EF of 59% +/- 3% and 24 women with a mean age of 59 +/- 10 y and EF of 60% +/- 3%), paired with regard to age, heart rate, and medical treatment by transthoracic echocardiography with the assessment of mitral and pulmonary vein flow parameters, propagation of mitral filling waves, and tissue Doppler variables of mitral annulus motion (MAM). The impact of gender was assessed separately for the healthy participants and the CAD group.
Results: In healthy participants, the velocity of mitral inflow early wave and the systolic velocity of the pulmonary vein flow were significantly higher in women than in men: 77 +/- 18 versus 65 +/- 19 cm/second (P < 0.05) and 64 +/- 14 versus 57 +/- 11 cm/second (P < 0.05), respectively. On the other hand, velocities of MAM in the atrial and systolic phases were higher in men than in women: 13 +/- 2 versus 12 +/- 2 cm/second and 11 +/- 2 versus 10 +/- 2 cm/second, respectively (P < 0.05). The opposite tendency was observed in the CAD group: the ratio of early mitral inflow velocity to atrial mitral inflow velocity was significantly higher in male patients (1.1 +/- 0.5 vs 0.8 +/- 0.2; P = 0.007) and there was a trend toward faster early wave propagation in men (40 +/- 9 vs 36 +/- 8 cm/s; P = 0.08).
Conclusions: Our data suggest more efficient early diastolic filling in postmenopausal women than in age-matched men in healthy participants but an opposite relationship in patients with CAD.