van Wezenbeek, Jessie and Groeneveldt, Joanne A. and Llucià-Valldeperas, Aida and van der Bruggen, Cathelijne E. and Jansen, Samara M.A. and Smits, A. Josien and Smal, Rowan and van Leeuwen, Joost W. and Remedios, Cris dos and Keogh, Anne and Humbert, Marc and Dorfmüller, Peter and Mercier, Olaf and Guignabert, Christophe and Niessen, Hans W.M. and Handoko, M. Louis and Marcus, J. Tim and Meijboom, Lilian J. and Oosterveer, Frank P.T. and Westerhof, Berend E. and Heijboer, Annemieke C. and Bogaard, Harm Jan and Vonk Noordegraaf, Anton and Goumans, Marie José and de Man, Frances S. (2022) Interplay of sex hormones and long-term right ventricular adaptation in a Dutch PAH-cohort. The Journal of Heart and Lung Transplantation, 41 (4). pp.445-457. ISSN 10532498
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Abstract
BACKGROUND: To investigate the association between altered sex hormone expression and long-term right ventricular (RV) adaptation and progression of right heart failure in a Dutch cohort of Pulmonary Arterial Hypertension (PAH)-patients across a wide range of ages. METHODS: In this study we included 279 PAH-patients, of which 169 females and 110 males. From 59 patients and 21 controls we collected plasma samples for sex hormone analysis. Right heart catheterization (RHC) and/or cardiac magnetic resonance (CMR) imaging was performed at baseline. For longitudinal data analysis, we selected patients that underwent a RHC and/or CMR maximally 1.5 years prior to an event (death or transplantation, N = 49). RESULTS: Dehydroepiandrosterone-sulfate (DHEA-S) levels were reduced in male and female PAH-patients compared to controls, whereas androstenedione and testosterone were only reduced in female patients. Interestingly, low DHEA-S and high testosterone levels were correlated to worse RV function in male patients only. Subsequently, we analyzed prognosis and RV adaptation in females stratified by age. Females </=45years had best prognosis in comparison to females >/=55years and males. No differences in RV function at baseline were observed, despite higher pressure-overload in females </=45years. Longitudinal data demonstrated a clear distinction in RV adaptation. Although females </=45years had an event at a later time point, RV function was more impaired at end-stage disease. CONCLUSIONS: Sex hormones are differently associated with RV function in male and female PAH-patients. DHEA-S appeared to be lower in male and female PAH-patients. Females </=45years could persevere pressure-overload for a longer time, but had a more severe RV phenotype at end-stage disease.
| Item Type: | Article |
|---|---|
| Subjects: | R Medicine > R Medicine (General) |
| Depositing User: | Repository Administrator |
| Date Deposited: | 07 Jun 2022 04:30 |
| Last Modified: | 17 Jun 2022 01:44 |
| URI: | http://eprints.victorchang.edu.au/id/eprint/1246 |
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