Objectives To identify gender difference in the associations between carotid intema-media thicknesss (CIMT) and cardiac diastolic function in healthy Chinese individuals.
Methods We examined 852 healthy participants (aged 30-98 years, 46% men) in three north China cities by M-mode ultrasonography to analyse CIMT and cardiac structure and function. Cardiac function was measured by determining the ratio of early diastolic peak flow velocity (E) and late diastolic peak flow velocity (A) (E/A), as well as the deceleration time of the early mitral velocity (MV-DT). Cardiac dysfunction was defined as E/A values <25th percentile (E/A < 0.778 for males and <0.792 for females), LAV values >75th percentile (LAV>34.86 ml for males and >32.16 ml for females), and MV-DT values >75th percentile (MV-DT > 210 ms for males and > 195 ms for females).
Results CIMT, E/A, LAV, and MV-DT significantly correlated with age in both males (CIMT: r = 0.418, P < 0.01; E/A: r = -0.325, P < 0.01, LAV: r = 0.123, P < 0.05; MV-DT: r = 0.175, P < 0.01) and females (CIMT: r = 0.429, P < 0.01; E/A: r = -0.423, P < 0.01; LAV: r = 0.180, P < 0.01; MV-DT: r = 0.174, P < 0.01). Interestingly, left ventricular ejection fraction (LVEF) was not significantly correlated with age in both genders. CIMT was significantly associated with lower E/A in an unadjusted model in tertile II and III. The odds ratio (95% CI) for males was 2.428 (1.36-4.335) and 3.017 (1.674-5.437), respectively. However, this association disappeared upon age adjustment. The odds ratio (95% CI) for females was 3.298 (1.742-6.246) and 6.002 (3.202-11.251), respectively, and were still significant after adjustments for all other variables, including age, blood pressure, blood lipid and inflammatory markers (tertile II: 3.031, 95% CI: 1.228-7.48; tertile III: 3.224, 95% CI: 1.308-7.946). A higher MV-DT significantly correlated with higher CIMT only in an unadjusted model for females, and this association was lost upon age adjustment. There were no significant association between CIMT and higher values of LAV.
Conclusions Aging related increases in CIMT correlated with the decline in cardiac diastolic function only in females, which may contribute to the higher incidence of heart failure with preserved ejection fraction.