Gender differences in risk factor profiles, structural and functional myocardial characteristics and heart failure biomarkers in urban population aged 35–69 years

INTRODUCTION: Cardiac structure, function and metabolism, as well as the immune system biology significantly differ in men and women. Identification of differences of the myocardial response to the concomitant diseases in women compared to men could provide insight into the mechanisms underlying heart failure (HF) in women and men. AIM: A comparative analysis of the cardiovascular risk profile, structural and functional myocardial parameters and heart failure biomarkers in the population of men and women, and investigation of gender differences in the relationships of these parameters with metabolic syndrome (MS). MATERIALS AND METHODS: The ‘Learn Your Heart’ cross-sectional study data were analyzed on a population sample aged 35–69 years (n = 2,380), of which 989 men (41.5%) and 1,391 women (58.5%). History data (bad habits, diseases) and laboratory data, including high-sensitivity troponin T (hs-TnT) and N-terminal propeptide of the brain natriuretic peptide (NT-proBNP) were used. The presence of MS was determined based on AHA/NHBLI 2009 criteria. Echocardiography was used to evaluate structural and functional parameters with phenotyping of systolic and diastolic dysfunction of the left ventricle (LV). RESULTS: Men were more likely to smoke and have a history of myocardial infarction, while women were more likely to have heart failure and diabetes (p 0.05 for all). Men had higher triglyceride levels, while women had higher body mass index and low-density lipoprotein cholesterol (all p 0.05). Ejection fraction and global longitudinal strain (GLS) of the LV, adjusted for bad habits and diseases (heart failure, diabetes, myocardial infarction), had lower values in men, and diastolic dysfunction of the LV was more distinct in women (p 0.001 for all). The hs-TnT level was higher in men, the frequency of elevated LV filling pressure (E/é) and NT-proBNP concentration exceeded 125 pg/ml in women (all p 0.05). In women, a stronger negative association was recorded between MS and the é lateral (p = 0.001), é septal (p = 0.003) and GLS (p = 0.013) of the LV. CONCLUSION: In a population sample aged 35–69 years, gender differences in the structural and functional heart characteristics were identified: lower values of ejection fraction and GLS of LV, higher hs-TnT levels in men and higher levels of LV filling pressure (E/é) and NT-proBNP and stronger negative relationships of MS with relaxation parameters (é lateral, é septal) and LV contractility in women.