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Results on Women and cardiac insufficiency: A clinical and biochemical approach.

Contributed by: Elhuyar Foundation

Doctor Elena Zubillaga studied 109 women and 120 men admitted to hospital with a cardiac insufficiency solely due to high blood pressure. More concretely, she analysed the clinical, biochemical and ecocardiographical differences between the patients, depending on their sex.
She also made reference to the data provided by serum markers for the metabolism of the collagen (protein) in the heart and the systolic function or contraction of the latter, as alterations taking place in the metabolism (processes of synthesis and degradation) of myocardial collagen are associated with certain clinical situations

With all the results, Ms Zubillaga presented a PhD thesis at the University of the Basque Country (UPV/EHU) entitled<i> Differential aspects of cardiac insufficiency due to high blood pressure amongst women and men. A clinical and biochemical approach</i>.

<b>Women 78, men 71</b>

According to Ms Zubillaga, there are certain differential features between the women and men suffering from cardiac insufficiency due to high blood pressure. Women tend to be older; amongst the patients studied, the average age of the women was 78, while amongst men it was 71. Also, women suffer more functionally when in a stable phase: both sexes tire with minimum physical effort, but females more so. In respect to the time of the onset of cardiac insufficiency, in the case of women, they spent on average 848 days from the first diagnosis to the moment of the study (hospital admission) on which the thesis was based; men 1,378 days. According to Ms Zubillaga, this could be due to various reasons, such as, for example, women have surgery later or their resistance to the illness is greater.

There are also differences between the sexes in respect to the fraction of ejection. This measures the strength that the heart has on contraction (in what proportion does the volume of the left ventricle contract when it is in systolic function), and the greater the better. The PhD concluded that the fraction of ejection of the heart amongst women is visibly greater than that amongst men: women show an average proportion of 62.4 %, while for men it is 53.8 %.

<b>Level of contraction of the heart is normal</b>

Although suffering from cardiac insufficiency, the results produced in the fraction of ejection were considered normal, especially amongst the women (the figures start to give cause for concern when it drops to 50 %). Dr Zubillaga explained that this could be due to stabilisation; i.e. after considerable worsening at the commencement of the illness, the situation tends to become calm. Precisely because of this, and as is concluded in the thesis, the older the patients are (whether men or women), the greater is the fraction of ejection.

As regards this same fraction of ejection, Dr Zubillaga also studied the metabolism of the myocardial collagen of the patients. No differences were found as regards gender, but there were with respect to age and the fraction of ejection. More concretely, serum markers for the process of degradation of the collagen show an inverse relationship with respect to age and the fraction of ejection. That is, the older the patient, besides the fraction of ejection being greater, the more the degradation of the collagen is reduced, independently of the sex.

<b>About the author</b>

Ms Elena Zubillaga Azpiroz (San Sebastián, 1980) has a degree in medicine. She drew up her degree under the direction of Ramón Querejeta, cardiologist at the Hospital Donostia, and presented it at the Department of Surgery and Medicine of the UPV/EHU in Basurto (near Bilbao). She carried out her thesis at the Teaching Unit in the San Sebastián Faculty of Medicine and Odontology (also part of the UPV/EHU), but also worked in collaboration with researchers at the Applied Medicine Research Centre (CIMA) of the University of Navarra. Currently, Ms Zubillaga is a doctor at the Hospital Donostia.

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    Zelai Haundi 3, Osinalde Industrialdea
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