1
|
House CM, Moriarty KA, Nelson WB. Sex difference in mitral valve prolapse regurgitant volume is resolved by normalization of regurgitant volume to left ventricular end-diastolic volume. THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2024:10.1007/s10554-024-03197-6. [PMID: 39105892 DOI: 10.1007/s10554-024-03197-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Accepted: 07/11/2024] [Indexed: 08/07/2024]
Abstract
Women with primary mitral insufficiency have a smaller regurgitant volume at the same regurgitant fraction than men. We hypothesized that normalizing regurgitant volume with left ventricular end-diastolic volume or allometric scaling would eliminate the difference in regurgitant volume between women and men. The study cohort consisted of 101 patients with mitral valve prolapse undergoing cardiac MRI. Descriptive statistics and linear regression were performed to assess differences between sexes. Of the 101 patients, 46 (46%) were women. Women had a significantly smaller left and right ventricular end-diastolic volume, end-systolic volume, and stroke volume. While there was no difference in regurgitant fraction between women and men (34 ± 13% vs. 35 ± 14%; p = 0.71), women had a significantly smaller regurgitant volume (36 ± 18 ml vs. 49 ± 26 ml; p = 0.005). The slope-intercept relationship between regurgitant fraction and regurgitant volume revealed unique slopes and y-intercept values for men and women (p-value < 0.0001). Normalizing regurgitant volume to left ventricular end-diastolic volume (RVol/LVEDV), body surface area1.5 (RVol/BSA1.5) and height2.7 (RVol/height2.7) all had essentially identical slope-intercept relationships with regurgitant fraction for men and women, but RVol/LVEDV had the smallest effect size. In mitral insufficiency secondary to mitral valve prolapse women have a significantly smaller regurgitant volume than men despite no difference in regurgitant fraction. The significant difference in regurgitant volume between women and men is secondary to women having a smaller left ventricular end-diastolic volume.
Collapse
Affiliation(s)
- Chad M House
- Department of Cardiology, Regions Hospital, Chad House, 640 Jackson Street, Mail Stop 11102M, St. Paul, MN, 55101, USA.
- HealthPartners Medical Group, Minneapolis, MN, USA.
| | - Katie A Moriarty
- Department of Cardiology, Regions Hospital, Chad House, 640 Jackson Street, Mail Stop 11102M, St. Paul, MN, 55101, USA
- HealthPartners Medical Group, Minneapolis, MN, USA
- University of Minnesota Medical School, Minneapolis, MN, USA
| | - William B Nelson
- Department of Cardiology, Regions Hospital, Chad House, 640 Jackson Street, Mail Stop 11102M, St. Paul, MN, 55101, USA
- HealthPartners Medical Group, Minneapolis, MN, USA
- University of Minnesota Medical School, Minneapolis, MN, USA
| |
Collapse
|
2
|
Almeida AG. Sex Differences in Primary Mitral Regurgitation Assessment: Highlighting the Role of Regurgitant Fraction. JACC. ADVANCES 2024; 3:101020. [PMID: 39129973 PMCID: PMC11312767 DOI: 10.1016/j.jacadv.2024.101020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/13/2024]
Affiliation(s)
- Ana G. Almeida
- Heart and Vessels Department, Cardiology, University Hospital Santa Maria, Faculty of Medicine of Lisbon University, CCUL@RISE, CAML, Lisbon, Portugal
| |
Collapse
|