Age-related differences in left ventricular structure and function between healthy men and women

Abstract

Objectives: Cardiovascular function generally decreases with age, but whether this decrease differs between men and women is unclear. Our aims were twofold: (1) to investigate age-related sex differences in left ventricular (LV) structure, function and mechanics, and (2) to compare these measures between pre- and postmenopausal women in the middle-aged group.

Methods: Resting echocardiography was performed in a cross-sectional sample of 82 healthy adults (14 young men, 19 middle-aged men, 15 young women, 34 middle-aged women: 15 premenopausal and 19 postmenopausal). Two-way ANOVAs were used to examine sex × age interactions, and t-tests to compare pre- and postmenopausal women (α < 0.1).

Results: Normalized LV mass, stroke volume and end-diastolic volume were significantly lower in middle-aged than young men, but this difference was smaller between middle-aged and young women. Peak systolic apical mechanics were significantly greater in middle-aged men than in middle-aged women, but not between young men and women. Postmenopausal women had significantly lower LV relaxation and mechanics (torsion, twisting velocity and apical circumferential strain rates) compared with middle-aged premenopausal women.

Conclusion: Our cross-sectional findings suggest that the hearts of men and women may age differently, with men displaying greater differences in LV volumes accompanied by differences in apical mechanics.

Keywords:

• Sex differences
• aging
• menopause
• left ventricular mechanics
• cardiac function

Acknowledgements

Amanda Nio is currently based at the Department of Biomedical Engineering, King’s College London, United Kingdom. The authors thank those who have assisted in data collection – Victoria Meah, Samantha Rogers, Rachel Mynors-Wallis, Jane Black, Mike Stembridge and Anke van Mil – and the study participants for their time and effort. The authors would also like to acknowledge Christoph Weidemann and Alessandro Faraci for helpful discussions regarding statistics.

Conflict of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Source of funding

Amanda Nio is the beneficiary of a doctoral grant from the AXA Research Fund. For the remaining authors none were declared.