Abstract 13856: Echocardiographic Findings in Women With Ischemic Sudden Cardiac Death

Abstract

Background: Majority of sudden cardiac deaths (SCD) are caused by coronary artery disease (CAD). Many women who experience SCD do not exhibit the traditional risk factors associated with SCD, which poses challenges in terms of SCD prevention and prediction. The data of SCD in women are limited as women are often underrepresented in SCD studies. Aim: The objective of this study was to investigate sex-specific echocardiographic findings in subjects with ischemic SCD. Methods: The study group consisted of 4392 subjects with ischemic SCD (20.2 % women) derived from the FinGesture study. The cause of death was determined at medicolegal autopsy. Pre-SCD echocardiography (ECHO) reports were collected from medical records. Ventricular and atrial dimensions as well as left ventricular mass (LVM) were categorized by using widely accepted thresholds. LVM was calculated using the LVM formula (LV Mass = (0.8 * [1.04 * ((LVEDD + IVSd + PWd) 3 - LVEDD 3 )]) + 0.6)). Left ventricular ejection fraction (LVEF) was classified into four categories: normal (>55 %), mildly reduced (45-55 %), moderately reduced (35-45 %) and severely reduced (<35 %). ECHO reports were available for 325 SCD victims (20.3 % women). Results: Left ventricular hypertrophy (LVH) was prevalent in 84.6 % of women and 76.4 % of men (p = 0.440). A thickened interventricular septum was observed in the majority of subjects in both sexes (84.8 % in women vs. 85.9 % in men, p = 1.000). Similarly, an enlarged left atrium was commonly found in both women (70.2 %) and men (72.3 %) (p = 0.856). The prevalence of dilated left ventricular end-diastolic diameter was 27.3 % in women and 30.1 % in men (p = 0.651). Overall, no significant differences were observed between the sexes in sex-adjusted ventricular or atrial dimensions. However, women with ischemic SCD were more likely to have a normal LVEF compared to men (63.4 % in women vs. 45.5 % in men, p <0.001). Additionally, the prevalence of severely reduced LVEF was significantly lower in women than in men (5.4 % in women vs. 15.9 % in men, p = 0.005). Conclusions: LVH is a common finding in subjects with ischemic SCD. Women with ischemic SCD are less likely than men to have severely reduced LVEF prior to SCD. Additionally, in women, ischemic SCD tends to occur more often without a decrease in LVEF.