Title : Gender differences in cardiac structure between older men and women
Abstract:
Background: Gender differences in cardiac structure may reflect body size and comorbidity patterns and have implications for diagnosis and risk stratification in older adults. The aim is to compare left ventricular wall thickness (LVWT) and left atrial (LA) size between older men and women.
Methods: Cross-sectional analysis of echocardiographic and clinical data from 978 adults aged ≥65 (men 509, women 469). Echocardiographic measures (using Philips Affiniti 70 scanner) included LVWT (mm), LVWT indexed to body surface area (mm/m2), LA volume (mL) and LA volume index (LAVI, mL/m2). Clinical covariates included age, body surface area (BSA), hypertension, BMI and left ventricular ejection fraction (LVEF). Between-gender comparisons used t-tests/chi-square tests; multivariable linear regression estimated the adjusted effect of male gender on each outcome.
Results: Mean age was 72.6 ± 5.7 years. Men had larger BSA than women (1.95 ± 0.15 vs 1.71 ± 0.13 m2, p < 0.001). Unadjusted comparisons showed greater absolute LVWT in men (11.8 ± 2.6 vs 10.6 ± 2.5 mm; mean difference 1.2 mm, 95% CI 0.9–1.5, p < 0.001) and larger LA volume (48.0 ± 14.2 vs 42.5 ± 13.6 mL; mean difference 5.5 mL, 95% CI 3.8–7.2, p < 0.001). After multivariable adjustment (age, BSA, hypertension, BMI, LVEF), male gender remained associated with a modestly greater absolute LVWT (β = +0.48 mm, 95% CI 0.18–0.78, p = 0.002) but not with LVWT indexed (β = −0.05 mm/m2, 95% CI −0.28–0.18, p = 0.66), LA volume (β = +1.2 mL, 95% CI −0.9–3.3, p = 0.27), or LAVI (β = −0.42 mL/m2, 95% CI −1.24–0.40, p = 0.31).
Conclusions: In this cohort of older adults, men had larger absolute LV wall thickness and LA volume than women but indexing for body size and adjustment for clinical covariates attenuated these differences.
