Gender differences in exercise capacity and left ventricular geometry among patients with comorbid pathology – hypertension with chronic obstructive pulmonary disease

Abstract

Hypertension (HT) and chronic obstructive pulmonary disease (COPD) are one of the most common comorbid pathologies associated with the risk of cardiovascular events. As long as the ejection fraction (EF) remains preserved, it is quite challenging to establish signs of heart failure. Dyspnea and exercise intolerance in COPD can mask reduced heart function, especially in hypertensive patients. Our aim was to assess gender differences in exercise capacity using 6-min walk test (6MWT) and left ventricular (LV) geometry among patients with HT and COPD. We found that dyspnea level before and after the 6MWT, drop in SpO2 during the 6MWT as well as the distance walked in the 6MWT showed no significant (p > 0,05) gender differences. LV systolic function was preserved in all patients (EF > 55 %). LV diastolic function echocardiographic parameters didn’t show significant differences between men and women. At the same time, we found that all women had unfavorable types of LV geometry (concentric and eccentric hypertrophy), concentric hypertrophy was predominated. All four types of LV geometry were found among men. Thus, despite the lack of differences in clinical and functional data by gender, the predominance of LV concentric hypertrophy in women was reliably established among the patients with HT and COPD.