Sex-Specific Associations of Risks and Cardiac Structure and Function With Microalbumin/Creatinine Ratio in Diastolic Heart Failure

Frontiers in Cardiovascular Medicine

Marvin Owusu-Agyeman²  Jiangui He²  Fang-Fei Wei²  Ruicong Xue²  Zexuan Wu²  Weihao Liang²  Yuzhong Wu²  Yuanyuan Zhou²  Wengen Zhu²  Xin He²  Chen Liu³  Yugang Dong³  Jan A. Staessen⁴ 

[1] Department of Cardiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China;NHC Key Laboratory of Assisted Circulation, Sun Yat-sen University, Guangzhou, China;National Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Disease, Guangzhou, China;Non-profit Research Institute (NPA) Alliance for the Promotion of Preventive Medicine, Mechelen, Belgium;Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium;

关键词: heart failiure;    chronic kindney disease;    echocardiography;    microalbuminuria;    risk stratification;    gender;   

DOI  :  10.3389/fcvm.2020.579400

来源: DOAJ

【 摘 要 】

Background: Heart failure with preserved ejection fraction (HFpEF) affects women more frequently than men. However, data on sex-specific associations of adverse health outcomes and left ventricular structure and function and with microalbuminuria in patients with HFpEF are scarce.Methods: In 1,334 participants enrolled in the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) Trial, we estimated the sex-specific multivariable-adjusted risk and LV traits with urine microalbumin/creatine ratio (ACR), using Cox or linear regression.Results: In total, 604 (45.3%) were women. In multivariable-adjusted analyses, a doubling of ACR in both men and women was associated with higher posterior (+0.014 cm, p = 0.012/+0.012 cm, p = 0.033) wall thickness and left ventricular mass index (+2.55 mg/m2, p = 0.004/+2.45 mg/m2, p = 0.009), whereas was also associated with higher septal (+0.018 cm, p = 0.002) and left atrial volume index (+1.44 mL/m2, p = 0.001) in men. ACR was a key predictor of all-cause (HR, 1.11; p = 0.006) and cardiovascular (HR, 1.17; p = 0.002) death in women, whereas in men ACR was associated with HF hospitalization (HR, 1.23; p < 0.001), any hospitalization (HR, 1.06; p = 0.006), and myocardial infarction (HR, 1.19; p = 0.017). The interactions of sex with ACR were significant for hospitalization for heart failure and any hospitalization (p ≤ 0.034).Conclusions: Outcomes and cardiac structure and function in patients with HFpEF appear to be influenced by ACR that vary according to sex. In men, ACR was significant associated with LV diastolic function, hospitalization, and myocardial infarction, whereas in women was associated with mortality.

【 授权许可】

Unknown