Gender Difference in the Association between Aortic Pulse Pressure and Left Ventricular Filling Pressure in the Elderly: An Invasive Hemodynamic Study

Abstract

BackgroundThis study was conducted to determine the association between aortic pulse pressure (APP) and left ventricular (LV) filling pressure in the elderly of both genders. MethodsA total of 211 stable elderly subjects (age ≥65 years, mean age 72.1 ± 5.2 years, 53.6% women) who underwent invasive coronary angiography (ICA) for the evaluation of coronary artery disease (CAD) were prospectively investigated. APP was measured in the ascending aorta using a pigtail catheter immediately before ICA. E/e′, reflecting LV filling pressure, was assessed by transthoracic echocardiography. ResultsThere were positive linear correlations between APP and E/e′ in both genders, but the correlation power was stronger in women than in men (r = 0.402, P < .001 vs r = 0.208, P = .040). The significance of this association between APP and E/e′ remained after controlling for potential confounders in multiple linear regression analysis in women (β = 0.359, P < .001), but not in men (r = 0.139, P = .108). ConclusionsInvasively measured APP is independently associated with E/e′ in elderly women, but not in elderly men undergoing ICA. Aortic stiffness may be a potential mechanism for more prevalent LV diastolic dysfunction and heart failure with preserved ejection fraction in elderly women.