MRI Shows Heart Ages Differently in Women than in Men

As patients age, the left ventricular (LV) responds differently in its mass and volume between men and women, although both men and women experience increased concentric LV remodeling with age. In men, the opposition of longitudinal and cross-sectional changes in LV mass highlights the importance of longitudinal study.

In an article published online in Radiology, John Eng, M.D., of the Russell H. Morgan Department of Radiology and Radiological Science at Johns Hopkins University School of Medicine, and colleagues used MR imaging to identify longitudinal changes in LV structure and function in 2,935 participants who underwent baseline and follow-up cardiac MR imaging in the Multi-Ethnic Study of Atherosclerosis. Participants were aged 54–94 years at follow-up, and 53 percent of the participants were women. Median time between baseline and follow-up cardiac MR imaging was 9.4 years.

Over this period, LV mass increased in men and decreased slightly in women (8.0 and -1.6 g per decade, respectively; P < .001). In both men and women, LV end-diastolic volume decreased (-9.8 and -13.3 mL per decade, respectively; P < .001), stroke volume decreased (-8.8 and -8.6 mL per decade, respectively; P < .001), and mass-to-volume ratio increased (0.14 and 0.11 g/mL per decade, respectively; P < .001). Change in LV mass was positively associated with systolic blood pressure and body mass index and negatively associated with treated hypertension and high-density lipoprotein cholesterol level. In men, the longitudinal LV mass increase was in contrast to a cross-sectional pattern of LV mass decrease.

The changes combined to produce significant increases in adverse remodeling of the LV, as shown by increasing mass-to-volume ratios in both men and women.

“The LV mass in men implies an underlying cohort effect that operates in a direction opposite of the age effect,” the authors write. “These results highlight the importance of longitudinal study and suggest sex-specific differences in age-related cardiac remodeling.”