Hypothesis: We investigated the hypothesis that there are prognostic differences in the importance of left ventricular (LV) mass and function between male and female patients hospitalized with heart failure.
Methods: Patients ≥60 years old hospitalized with New York Heart Association class II–IV heart failure and LV systolic dysfunction were prospectively followed for ≥18 months. At study start, a physical examination and echocardiography were performed, and blood chemistry samples were obtained.
Results: Of 158 patients, 66 (42%) women were included and were followed for a mean of 3.1 years. The women were older (77 ± 7 vs. 74 ± 7 years, p < 0.01) and had lower mortality (24% vs. 43%, p < 0.05) than the men. No gender differences in etiology or medication were found. LV mass index (LVMI 132 ± 42 vs. 156 ± 21 g/m2, p < 0.01) was lower in women. Mortality in women was related to lower LV ejection fraction, larger LV volumes, and higher LVMI (all p < 0.05). In multivariate analysis, LVMI was the strongest independent mortality predictor in women (adjusted hazard ratio [HR] LMVI >125 g/m2 7.4 [1.5–35.5], p = 0.01), whereas this association was not found in men.
Conclusions: In patients hospitalized with systolic heart failure, women had lower mortality than men. In women, an increased LVMI was a stronger predictor of mortality than traditional measures of LV size and function. LVMI should be considered for assessment of prognosis in women with heart failure.
