THE ROLE OF GENDER IN CONGESTION STATUS EVALUATION IN PATIENTS WITH ACUTE HEART FAILURE

Abstract Background The evaluation of congestion play a central role in the management of patients with acute heart failure (AHF).The impact of gender on congestion in patients with HF is still a matter of debate. The objective of this analysis was to evaluate the impact of gender on congestion status at admission of patients hospitalized for AHF. Methods We consecutively enrolled 487 patients with AHF (50% female). We assessed peripheral edema, jugular venous distention (>10 cm), B–type natriuretic peptide (BNP), hydration status (by means of bioimpedance analysis), and estimated plasma volume (by means of the Duarte’s formula [D–ePVS] and Kaplan–Hakim formula [KH–ePVS]). Results Home medications and body mass index were not different between women and men. Women were older (79 yrs vs 77 yrs, P = 0.005), showed better left ventricular ejection fraction (mean 50% vs 38%, P < 0.001), and increased plasma concentrations in blood urea nitrogen (40 mg/dL vs 25 mg/dL, P = 0.02) and serum creatinine (1.5 mg/dL vs 1.5 mg/dL, P = 0.8). At physical examination, the number of patients with peripheral edema and jugular venous distention was not significantly different between women and men (53% vs 45% and 60% vs 55%, respectively). BNP levels (median 1100 pg/mL vs 994 pg/mL) and hydration status (78% vs 79%) were similar in women and men, while ePVS was higher in women (D–ePVS 6.0 ± 1.6 dL/gr vs 5.1 ± 1.5 dL/gr, P < 0.001; KH–ePVS 7.9% ± 13% vs –7.3 ±12%, P < 0.001). Conclusions The evaluation of congestion in AHF using physical examination and multiparametric approaches was similar between women and gender. Women rather showed higher plasma volume as compared to male individuals.