TABLE 4 ].
Cardiac, Echocardiographic, and Hemodynamic Measures by Sex in Patients With Pulmonary Hypertension
| Variable | No. | Male (n = 279) | Female (n = 471) | Adjusted Differencea | P Valueb |
|---|---|---|---|---|---|
| Cardiac MRI | |||||
| RV ejection fraction, % | 449 | 37.3 ± 10.8 (n = 163) | 41.6 ± 12.3 (n = 286) | −5.5 (−7.8 to −3.2) | < .001 |
| RV ejection fraction ≤ 35% | 149 | 67 (41.1) | 82 (28.7) | … | .001c |
| RV stroke volume index, mL/m2 | 449 | 37.1 ± 10.3 (n = 163) | 37.4 ± 11.4 (n = 286) | 0.14 (−2.1 to 2.4) | .90 |
| RV EDV index, mL/m2 | 449 | 106.4 ± 41.8 (n = 163) | 96.2 ± 35.2 (n = 286) | 15.6 (8.2–23.1) | < .001 |
| RV mass index, g/m2 | 448 | 21.5 ± 8.7 (n = 162) | 18.9 ± 9.1 (n = 286) | 4.0 (2.2–5.8) | < .001 |
| LV ejection fraction, % | 451 | 52.9 ± 9.5 (n = 165) | 57.5 ± 8.5 (n = 286) | −4.3 (−6.2 to −2.4) | < .001 |
| RV EDV to LV EDV | 448 | 1.54 ± 0.5 (n = 163) | 1.55 ± 0.67 (n = 285) | 0.07 (−0.06 to 0.19) | .41 |
| RV mass to RV EDV, g/mL | 448 | 0.21 ± 0.06 (n = 162) | 0.20 ± 0.06 (n = 286) | 0.01 (0.00–0.03) | .11 |
| TTE | |||||
| RV fractional shortening, % | 603 | 29.5 ± 9.5 (n = 220) | 32.4 ± 9.9 (n = 383) | −4.0 (−5.8 to −2.3) | < .001 |
| RV free-wall longitudinal strain, % | 508 | −17.6 ± 5.6 (n = 175) | −19.5 ± 6.1 (n = 333) | 2.4 (1.2–3.6) | < .001 |
| TAPSE, cm | 593 | 1.79 ± 0.47 (n = 221) | 1.87 ± 0.48 (n = 372) | −0.08 (−0.16 to 0.01) | .12 |
| RV systolic pressure, mm Hg | 612 | 59.3 ± 19.6 (n = 219) | 61.8 ± 23.4 (n = 393) | 1.6 (−2.2 to 5.4) | .51 |
| TAPSE, mm to RVSP, mm Hg | 513 | 0.34 ± 0.16 (n = 186) | 0.36 ± 0.19 (n = 327) | −0.005 (−0.008 to −0.001) | .02 |
| RV ED basal diameter index, cm/m2 | 644 | 2.31 ± 0.48 (n = 240) | 2.34 ± 0.50 (n = 404) | 0.04 (−0.03 to 0.12) | .35 |
| RA volume index, mL/m2 | 689 | 37.4 ± 20.1 (n = 251) | 31.6 ± 17.5 (n = 438) | 8.7 (5.4–11.9) | < .001 |
| LA volume index, mL/m2 | 627 | 28.5 ± 14.1 (n = 228) | 26.0 ± 12.0 (n = 399) | 0.8 (−1.3 to 3.0) | .53 |
| LV ejection fraction, % | 514 | 57.4 ± 11.3 (n = 193 | 62.6 ± 8.8 (n = 321) | −4.5 (−6.0 to −3.0) | < .001 |
| Global LV strain, % | 449 | −16.8 ± 3.8 (n = 158) | −17.9 ± 3.3 (n = 291) | 0.9 (0.1–1.6) | .04 |
| Tricuspid valve regurgitation | 703 | … | … | … | .56c |
| None or trace | … | 81 (31.2) | 123 (27.8) | … | … |
| Mild | … | 99 (38.1) | 177 (40.0) | … | … |
| Moderate | … | 68 (26.2) | 112 (25.3) | … | … |
| Severe | … | 12 (4.6) | 31 (7.0) | … | … |
| Right heart catheterization | |||||
| PVR, WU | 714 | 5.72 ± 4.13 (n = 261) | 6.31 ± 4.26 (n = 453) | 0.30 (−0.36 to 0.95) | .49 |
| PVR > 5 WU | … | 118 (45.2) | 237 (52.3) | … | .62c |
| Mean PA pressure, mm Hg | 736 | 40.2 ± 12.5 (n = 270) | 41.0 ± 13.9 (n = 466) | 2.7 (0.6–4.8) | .02 |
| Mean RA pressure, mm Hg | 736 | 8.8 ± 4.9 (n = 271) | 7.7 ± 5.1 (n = 465) | 1.40 (0.64–2.15) | .001 |
| Mean PCWP, mm Hg | 730 | 13.2 ± 6.3 (n = 268) | 12.6 ± 6.5 (n = 462) | 0.3 (−0.6 to 1.1) | .58 |
| Cardiac index, L/min/m2 | 724 | 2.63 ± 1.01 (n = 265) | 2.76 ± 0.86 (n = 459) | −0.13 (−0.28 to 0.02) | .15 |
| PA compliance, mL/mm Hg | 722 | 2.45 ± 1.43 (n = 265) | 2.14 ± 1.46 (n = 457) | 0.17 (−0.06 to 0.40) | .23 |
Data presented as No. (%), mean ± SD, or median (interquartile range) unless otherwise indicated. The n values are the number of nonmissing values. Numbers after proportions are frequencies. ED = end diastolic; EDV = end diastolic volume; LA = left atrium; LV = left ventricle; PA = pulmonary artery; PCWP = pulmonary capillary wedge pressure; PVR = pulmonary vascular resistance; RA = right atrium; RV = right ventricle; RVSP = right ventricular systolic pressure; TAPSE = tricuspid annular plane systolic excursion; TTE = transthoracic echocardiography; WU = Wood unit.
Adjusted difference, estimated regression coefficient, presents the effect of sex (male vs female) estimated via multivariable regression model adjusted for age, BMI, World Health Organization functional class, World Symposium on Pulmonary Hypertension group, years of pulmonary hypertension at time of enrollment, current exercise frequency and duration, smoking status, history of atrial arrhythmia, diabetes, kidney disease, and coronary disease.
Adjusted for multiple comparisons by controlling false discovery rate at 0.05. Unless otherwise indicated, P values are from multivariable linear regression model.
Pearson χ2 test.