Sex-related differences in the associations between plasma free fatty acid levels and clinical features in patients with hypertrophic cardiomyopathyReportar como inadecuado

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Biology of Sex Differences

, 7:63

First Online: 25 November 2016Received: 11 October 2016Accepted: 15 November 2016


BackgroundPrevious studies have indicated that inefficient energy utilization may play a pivotal role in hypertrophic cardiomyopathy HCM. However, whether plasma free fatty acid FFA, a main energy substrate of heart, has an effect on HCM remains unclear. Besides, several studies have suggested sex-related differences in HCM features and FFA metabolism. Here, we aimed to explore the association between plasma FFA levels and HCM and potential effects of sex on this relation.

MethodsA total of 412 patients age 47.8 ± 12.7 years, 243 males 59.0% with HCM were recruited. Complete medical history was collected. Echocardiography and cardiovascular magnetic resonance imaging CMRI were performed. Fasting plasma FFA was determined by clinical laboratory. Left ventricular mass LVM, maximum wall thickness MWT, and left atrium diameter LAD were assessed with CMRI.

ResultsThe median FFA levels were 0.38 interquartile range IQR 0.27–0.52 mmol-L in men and 0.40 IQR 0.30–0.59 mmol-L in women. The FFA levels were significantly lower in men compared with those in women p = 0.005. Compared with women, men had greater LVM index LVMI 96.8 ± 37.6 vs. 78.6 ± 31.5 g-m, p < 0.001. FFA levels in male patients correlated positively with LVM, LVMI, LAD, cholesterol levels, high-density lipoprotein-cholesterol HDL-C levels, heart rate, and systolic blood pressure SBP. However, none of these variables were significantly associated with sqrt FFA in female patients except a borderline correlation of LAD p = 0.050. Multiple linear regression analysis was performed in male patients and revealed that HDL-C β = 0.191, p = 0.002, heart rate β = 0.182, p = 0.004, SBP β = 0.167, p = 0.007, LVMI β = 0.132, p = 0.032, and LAD β = 0.165, p = 0.009 were independently associated with increasing FFA levels.

ConclusionsIn patients with HCM, LVMI, LAD, HDL-C, SBP, and heart rate were independently associated with increasing plasma FFA levels in males, whereas not in females. These results suggest that sex may affect the pathogenesis of HCM through influencing FFA metabolism. And these sex-related differences should be taken into account in therapeutic approaches to influence myocardial FFA metabolism in HCM.

KeywordsHypertrophic cardiomyopathy Free fatty acid Sex Left ventricular mass index Left atrium diameter AbbreviationsBMIBody mass index

CMRICardiovascular magnetic resonance imaging

FFAFree fatty acid

HCMHypertrophic cardiomyopathy

LADLeft atrium diameter

LVLeft ventricular

LVEFLeft ventricular ejection fraction

LVMLeft ventricular mass


LVOTLeft ventricular outflow tract

MWTMaximum wall thickness

SBPSystolic blood pressure

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Autor: Chengzhi Yang - Changlin Zhang - Jiansong Yuan - Jingang Cui - Shengwen Liu - Fenghuan Hu - Weixian Yang - Xuanye Bi - Shu


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