Evaluation of sex differences in the relationship between diastolic dysfunction and thromboembolism using propensity score analysis

Background Female sex is a risk factor for thromboembolism (TE) in atrial fibrillation (AF); however, the underlying mechanisms are unclear. We postulated that left ventricular (LV) diastolic dysfunction (LVDD) could be associated with increased thromboembolic risk in women. Methods From a retrospec...

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Bibliographic Details
Published in:Echocardiography (Mount Kisco, N.Y.) N.Y.), 2018-06, Vol.35 (6), p.817-826
Main Authors: Kim, Mi‐Na, Shim, Jae‐Min, Choi, Jong‐il, Park, Seong‐Mi, Kim, Young Hoon, Shim, Wan Joo
Format: Article
Language:English
Subjects:
atrial fibrillation
diastolic dysfunction
embolism
sex difference
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Summary:Background Female sex is a risk factor for thromboembolism (TE) in atrial fibrillation (AF); however, the underlying mechanisms are unclear. We postulated that left ventricular (LV) diastolic dysfunction (LVDD) could be associated with increased thromboembolic risk in women. Methods From a retrospective cohort, 158 patients (female : male = 79:79) with nonvalvular AF were propensity score‐matched for age, presence of diabetes, hypertension, coronary artery disease, congestive heart failure, embolic history, AF type, and AF duration. Cardiac size and function and central aortic stiffness parameters were evaluated. Diastolic function was classified as normal, indeterminate, and LVDD according to recent guidelines. Surrogate markers for thromboembolism (dense spontaneous echo contrast and thrombus) were evaluated using transesophageal echocardiography. Results Surrogate markers for TE showed a trend to be more frequent in women than in men (21.5% vs 11.4%, P = .086). LVDD was more prevalent in women than in men (22.8% vs 2.5%, P 
ISSN:0742-2822
1540-8175
DOI:10.1111/echo.13843