TY - JOUR
T1 - Sex-Associated Differences in Cardiac Reverse Remodeling in Patients Supported by Contemporary Left Ventricular Assist Devices
AU - Kenigsberg, Benjamin B.
AU - Majure, David T.
AU - Sheikh, Farooq H.
AU - Afari-armah, Nana
AU - Rodrigo, Maria
AU - Hofmeyer, Mark
AU - Molina, Ezequiel J.
AU - Wang, Zuyue
AU - Boyce, Steven
AU - Najjar, Samer S.
AU - Mohammed, Selma F.
N1 - Funding Information:
We thank Dr. Michael Hockstein. None. Dr. Najjar received grant support from Medtronic and consulting fees from Abbott and is a site principal investigator for the Medtronic ENDURANCE and LATERAL trials. Dr. Sheikh is a site principal investigator for the MOMENTUM trial sponsored by Abbott. The MOMENTUM trial assessed the clinical utility of the HeartMate 3. Patients with a HeartMate 3 LVAD were not included in this analysis. Dr. Sheikh received consulting fees from Alnylam and Pfizer and served as an advisor for the 2 companies. Dr. Mohammed is a site principal investigator for the PREVENT II trial sponsored by Abbott and DT PAS+Apogee study sponsored by Medtronic. Dr. Mohammed is the principal investigator for STEMVAD trial that is in part sponsored by CardioCell, LLC.
Funding Information:
Dr. Najjar received grant support from Medtronic and consulting fees from Abbott and is a site principal investigator for the Medtronic ENDURANCE and LATERAL trials. Dr. Sheikh is a site principal investigator for the MOMENTUM trial sponsored by Abbott. The MOMENTUM trial assessed the clinical utility of the HeartMate 3. Patients with a HeartMate 3 LVAD were not included in this analysis. Dr. Sheikh received consulting fees from Alnylam and Pfizer and served as an advisor for the 2 companies. Dr. Mohammed is a site principal investigator for the PREVENT II trial sponsored by Abbott and DT PAS+Apogee study sponsored by Medtronic . Dr. Mohammed is the principal investigator for STEMVAD trial that is in part sponsored by CardioCell, LLC.
Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2020/6
Y1 - 2020/6
N2 - Background: Women differ from men in their left ventricular (LV) structure, function and remodeling with age and diseases. The LV assist device (LVAD) unloads the LV and reversely remodels the heart. We sought to define the effects of sex on longitudinal reverse remodeling after LVAD implantation. Methods and Results: Cardiac structure and function were assessed by serial echocardiograms. Mixed effect regression models were constructed to assess the independent contribution of sex to longitudinal changes in cardiac structure and function. A total of 355 consecutive patients with advanced heart failure received continuous flow LVADs between 2006 and 2016. The average age was 56 ± 13 years, 73% were men, and 67% were black. Early (within 3 months) after LVAD implantation, women had a greater reduction in LV dimensions and a greater increase in LV ejection fraction compared with men. These differences were independent of age, body surface area, device type, or ischemic etiology of heart failure. At long-term follow-up, LV dimensions increased slightly over time in women compared with men, but overall, earlier changes were maintained. Conclusion: Women had significantly more favorable longitudinal changes in cardiac structure and function in response to LV unloading compared with men. Understanding the cause of sex difference in reverse remodeling after LVAD may help to devise novel therapeutic strategies for women with advanced heart failure.
AB - Background: Women differ from men in their left ventricular (LV) structure, function and remodeling with age and diseases. The LV assist device (LVAD) unloads the LV and reversely remodels the heart. We sought to define the effects of sex on longitudinal reverse remodeling after LVAD implantation. Methods and Results: Cardiac structure and function were assessed by serial echocardiograms. Mixed effect regression models were constructed to assess the independent contribution of sex to longitudinal changes in cardiac structure and function. A total of 355 consecutive patients with advanced heart failure received continuous flow LVADs between 2006 and 2016. The average age was 56 ± 13 years, 73% were men, and 67% were black. Early (within 3 months) after LVAD implantation, women had a greater reduction in LV dimensions and a greater increase in LV ejection fraction compared with men. These differences were independent of age, body surface area, device type, or ischemic etiology of heart failure. At long-term follow-up, LV dimensions increased slightly over time in women compared with men, but overall, earlier changes were maintained. Conclusion: Women had significantly more favorable longitudinal changes in cardiac structure and function in response to LV unloading compared with men. Understanding the cause of sex difference in reverse remodeling after LVAD may help to devise novel therapeutic strategies for women with advanced heart failure.
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U2 - 10.1016/j.cardfail.2020.03.005
DO - 10.1016/j.cardfail.2020.03.005
M3 - Article
C2 - 32200097
AN - SCOPUS:85084141582
VL - 26
SP - 494
EP - 504
JO - Journal of Cardiac Failure
JF - Journal of Cardiac Failure
SN - 1071-9164
IS - 6
ER -