PT  - JOURNAL ARTICLE
AU  - Pia Trip
AU  - Frances S. de Man
AU  - Harm J. Bogaard
AU  - Nico Westerhof
AU  - Anton Vonk-Noordegraaf
TI  - Gender differences in right-ventricular arterial coupling in idiopathic pulmonary arterial hypertension
DP  - 2013 Sep 01
TA  - European Respiratory Journal
PG  - P3414
VI  - 42
IP  - Suppl 57
4099  - http://erj.ersjournals.com/content/42/Suppl_57/P3414.short
4100  - http://erj.ersjournals.com/content/42/Suppl_57/P3414.full
SO  - Eur Respir J2013 Sep 01; 42
AB  - Introduction Male sex is an independent predictor of prognosis in idiopathic pulmonary hypertension (IPAH). We aimed to: 1) assess baseline gender differences in load-independent right ventricular (RV) systolic function and RV-arterial coupling, 2) assess the influence of baseline RV-arterial coupling on the gender-specific survival difference.Methods In 86 treatment naïve IPAH patients we determined RV end-systolic elastance (Ees), arterial elastance (Ea), RV-arterial coupling (Ees/Ea) and survival. Right heart catheterization was used to measure mean pulmonary artery pressure (mPAP) and stroke volume (SV). Maximal isovolumic pressure (Piso) was estimated from RV pressure curves with the single-beat method. Ees=(Piso-mPAP)/SV and Ea=mPAP/SV.Results Baseline hemodynamics are shown in table 1. Figure 1 shows Ees, Ea, and Ees/Ea. Male (N=29) and female patients (N=57) showed similar Ees- (p=0.08) and Ea–values (p=0.66). However, Ees/Ea was lower in males (p<0.05). A total of 20 patients died during follow-up. Kaplan-Meier analysis showed a worse survival for male patients independent of Ees/Ea (log-rank p<0.01).Conclusions Male IPAH patients present with a lower RV-arterial coupling ratio compared to females, despite a similar afterload level. The lower baseline coupling ratio does not explain the observed survival difference between males and females.