• Shiro Hoshida, Tetsuya Watanabe, Yukinori Shinoda, Kuniyasu Ikeoka, Tomoko Minamisaka, Hidetada Fukuoka, Hirooki Inui, Keisuke Ueno, Shinichiro Suna, Daisaku Nakatani, Shungo Hikoso, Takahisa Yamada, Yoshio Yasumura, Hisakazu Fuji, Yasushi Sakata, and PURSUIT HFpEF Investigators.
• Department of Cardiovascular Medicine, Yao Municipal Hospital, Osaka, Japan.
• Clin Cardiol. 2018 Dec 1; 41 (12): 1529-1536.

BackgroundWe previously reported that an index of afterload-related left ventricular diastolic function, operant diastolic elastance (Ed)/effective arterial elastance (Ea) = E/e'/(0.9 × systolic blood pressure), was significantly higher in elderly hypertensive women. We aimed to determine sex-related differences in the E/e'-related indices for left ventricular diastolic function and their related factors during admission in patients with heart failure with preserved ejection fraction (HFpEF).HypothesisElderly HFpEF women exhibit severe left ventricular diastolic dysfunction associated with different left atrioventricular volume ratio.MethodsWe divided 267 patients with HFpEF (men/women, 116/151) into two groups by age (≥75 years, n = 212; <75 years, n = 55). We examined the alterations of E/e', E/e'/stroke volume index = Ed, and Ed/Ea, and cardiac structure during admission.ResultsEd and Ea were significantly higher in women than in men, at admission, especially in patients ≥75 years. Before discharge, not only Ed and Ea but also Ed/Ea was significantly higher in women than in men, especially in patients ≥75 years. Elderly female patients had larger left atrial than left ventricular volume.ConclusionsHigher afterload-related left ventricular diastolic elastance, Ed/Ea, in association with higher arterial elastance, Ea, accompanied by left atrioventricular volume mismatch was observed in elderly HFpEF women.© 2018 Wiley Periodicals, Inc.

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