P1419 Sex-related differences in cardiac remodeling in health and hypertension

Abstract Funding Acknowledgements National Medical Research Council OnBehalf National Heart Centre Singapore BACKGROUND Adverse cardiac remodelling is associated with worse cardiovascular outcomes. Development of left ventricular hypertrophy (defined as increased myocardial mass) is a complex process mediated by myocardial wall thickening and/or ventricular dilatation. Sex-related differences in the relationship between myocardial mass and wall thickening/ventricular dilatation have not been well-described. PURPOSE We examine differences in determinants and patterns of cardiac remodeling between males and females. METHODS Comprehensive cardiovascular magnetic resonance imaging was performed in 1006 participants: 316 healthy volunteers (50% males, 46 ± 14 years) and 690 asymptomatic hypertensive patients (60% males, 57 ± 11 years). Myocardial mass, ventricular volumes and maximal myocardial wall thickness (across 16 myocardial segments) were measured using standardized contouring techniques. Clinically relevant variables (age, weight, height, and adiposity) that demonstrated significant univariate association with myocardial mass (P < 0.05) were selected in the multivariable linear regression model using the forward approach. RESULTS Increased body weight, lower body fat composition and higher systolic blood pressures were independently associated with increased myocardial mass in healthy volunteers (males and females) and hypertensive females. In hypertensive males, only increased body weight and elevated systolic blood pressure were independently associated with increased myocardial mass. The association between myocardial mass and ventricular volumes was almost identical between males and females (P = 0.65 for interaction; Figure). Conversely, there was a significant gender-related difference in the association between wall thickness and myocardial mass after adjusting for potential confounders (P < 0.001 for interaction). Concentric remodeling was initially more evident in males; but further with increase, myocardial mass was associated with greater concentric remodeling in females (Figure). Similar results were observed when analyses were performed separately in healthy volunteers and hypertensive patients. CONCLUSION There were sex-related differences in concentric remodeling at progressive stages of myocardial hypertrophy that may explain the higher prevalence of heart failure with preserved ejection fraction reported in females. Abstract P1419 Figure