Abstract 17174: Discrepancies in Development of Cardiac Myopathy in Males vs. Females

Abstract

Introduction: Heart disease has proven to be the leading cause of mortality in women. Sudden Cardiac Death being responsible for 1 in 4 female deaths, of these women 64% display no prior symptoms. Structural remodeling associated with fibrosis, however, has been strongly linked to development of cardiovascular disease (CVD), risk factors, and co-morbidities. This study aims to provide a preliminary assessment of fibrosis manifestation in women in comparison to their male counterparts. Methods & Results: Atrial Fibrillation (AF) patients (370 male, 197 female) with Late-Gadolinium Enhanced MRIs (LGE-MRI) were processed for fibrosis. Collected data included: CHADS-VASc factors, age and AF type. These two groups were matched in terms of cardiovascular co-morbidities. The LGE-MRI pre-ablation showed women had significantly higher LA fibrosis than men (17.2 ± 9.5 vs 14.6 ± 7.6, p <0.001), this difference remained true even after stratifying based on Paroxysmal (women 15.6 ± 7.9 vs men 13.8 ± 6.5, p =0.04) and Persistent types of AF (women 19.9 ± 11 vs men 15.3 ± 8.4, p =0.002). Women at the time of LGE-MRI scan were older (72.2 ± 11.1 vs 67.8 ± 11.6, p <0.001) and a majority of them were older than 75-years-old (40.1%), whereas the majority of men were 65 to 74-years-old (41.6%). After adjusting for age, the result of our regression model showed female gender contributes to 3.5% more LA fibrosis (CI 95% 0.53 - 6.6%, p =0.02). Conclusions: Given the obtained results, it can be concluded that women should be screened for cardiac symptoms starting at an early age. Women present with CVD symptoms at an older age along with higher fibrosis percentage at their initial visit in comparison to their male counterpart. Further research is recommended to determine what factors are associated to this discrepancy.