engleski

The influence of gender disparities on the development of heart failure and the relation to fetal programming

Purpose: Low birth weight is an important predictor of infant health and survival, and is associated with significant mortality and development of multiple diseases in adulthood including an increased cardiovascular risk. Incidence of LBW in the general population is around 5-10%, with several studies showing that female neonates have better outcomes in the perinatal period. Considering this data, if perinatal cardiovascular remodeling is a risk factor for the development of the adult cardiovascular disease, there should be more female patients with both a cardiovascular disorder and a personal history of LBW in our studied group of heart failure patients. Patients and Methods: 628 adult patients with different types of cardiomyopathies were admitted to our Department during 2012-2013. From that number, we studied 132 patients with known birth weight (88 male and 44 female). 49 had idiopathic DCM (iDCM), 37 had ischemic cardiomyopathy (ICM), 20 patients had secondary cardiomyopathy (valvular, toxic or hypertensive), 14 patients had postmyocarditic cardiomyopathy, 5 patients had hypertrophic cardiomyopathy, 5 patients had arrhythmogenic right ventricular dysplasia, and 2 patients had restrictive cardiomyopathy. The cut-off value for LBW was set at 2, 500 g. Gender differences between the normal birth weight and low birth weight groups are shown in Table 1. Results: In the both idiopathic dilated cardiomyopathy and postmyocarditic cardiomyopathy subgroups, the ratio of LBW to normal birth weight (NBW) patients was observed to be higher among the females than the males (28.6% of all female iDCM pts were of LBW while only 5.7% were male pts ; 33.3% of all female postmyocarditic cardiomyopathies were of LBW, compared to 12.5% male pts). On the other hand, all LBW patients in ischemic cardiomyopathy group were the males. Conclusion: We observed a larger share of female LBW patients than male LBW patients in the iDCM and postmyocarditic groups, suggesting a relation with fetal programming and later development of iDCM and myocarditis. Conversely, females may be protected from ischaemic cardiomyopathy, independent of fetal conditions.

heart failure; low birth weight; cardiomyopa- thy; gender

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