Sex-based Differences and Determinants of Right-Ventricular Function and Right Ventricular-Pulmonary Arterial Adaptations in Older Adults #MMPMID41389039
S/O Senthamil Selvan V; Wong JJ; Zhao X; Leng S; Tan GH; Loh J; Zhong L; Gao F; Tan RS; Koh AS
Am J Physiol Heart Circ Physiol 2025[Dec]; ? (?): ? PMID41389039show ga
Compared with left ventricular (LV) remodelling in cardiac ageing, right ventricular (RV) adaptations to pulmonary arterial (PA) changes are less well characterised. We evaluated CMR-derived indices of RV function and a volume-based surrogate of RV-PA coupling in community-dwelling older adults without cardiovascular disease. Participants underwent cardiac magnetic resonance with assessment of RV volumes (EDV, ESV), function (RVEF, RV global longitudinal strain [RVGLS]) and RV-PA coupling (LV stroke volume/RVESV). An RV-PA ratio >1.5 indicated effective adaptation. We studied 255 participants (54.5% female, 70.8+/-9.1 years) with normal biventricular function (mean LVEF 65.1+/-7.5%, RVEF 64.3+/-7.0%). RV-PA <1.5 was associated with lower RVEF (56.6% vs 67.5%, p<0.001), less negative RVGLS (-28.1% vs -32.8%, p=0.007) and higher indexed RVEDV (73.2 vs 63.3 ml/m(2), p<0.001). Female sex independently predicted more favourable RV indices (better RVGLS and smaller RVESV), whereas higher BMI and older age were associated with larger RVESV. Compared with men, women had higher RVEF and more negative RVGLS, but lower RV stroke volume and peak VO(2), and higher RV-PA ratios (2.1 vs 1.8, p<0.001). Female sex remained independently associated with higher RV-PA ratio. In healthy, community-dwelling older adults, CMR-derived measures characterise RV function and a surrogate of RV-PA interaction, with women demonstrating more favourable right heart phenotype and higher RV-PA ratios than men within this cohort. These findings highlight sex-related differences in RV adaptation to ageing not captured by LV-focused assessment. As a cross-sectional study, they should be interpreted as physiological reference data rather than prognostic.
Am+J+Physiol+Heart+Circ+Physiol 2025 ; ? (?): ?
