Sex differences in the effects of amiodarone and sotalol on left atrioventricular remodeling in patients with recurrent atrial fibrillation

Aim

To investigate the impact of gender on the left atrioventricular remodeling properties of class III antiarrhythmic drugs in patients with coronary artery disease (CAD), hypertension and recurrent atrial fibrillation (AF).

Material and methods

There was no difference between left atrial (LA) structural and functional parameters in men and women. However, in women LV diastolic function was worse: E/E’ (13 vs 11,2; p=0,03) and E/E’/LV-end diastolic volume (LVEDV) (0,13 vs 0,09 ml-1; p=0,001). Despite comparable changes in heart rate and blood pressure, LA volume index (-4 vs -1 ml/m2; p=0,03) as well as PALS (2,0 vs 0,7%; p=0,001) and PACS (-1,8 vs -1,6%; p=0,02) improved more significantly in men. Significant improvement in diastolic function was also observed in male patients only. However, only women had intergroup differences in E’, E/E’, E/E’/LVEDV with complete and partial antiarrhythmic response.

Results

Despite similar LA structural and functional parameters, females compared with males had more pronounced diastolic dysfunction that may contribute to their greater predisposition for heart failure with preserved ejection fraction. During treatment, structural and functional LA and LV parameters in male patients improved more significantly than in females. However, the association between antiarrhythmic efficacy and diastolic function at the end of treatment was observed only in women.

Key words

Atrialfibrillation, genderdifferences, diastolic function, amiodarone, sotalol.