The lack of gender differences in global longitudinal strain among patients after orthotopic heart transplantation during the 2-year observation period

Abstract Background/Introduction In recent years, there have been scientific reports indicating differences in mortality risk and survival rates between females and males after orthotopic heart transplant (HTx). Understanding the mechanisms underlying these disparities is crucial for developing more tailored treatment strategies that take into account individual patient characteristics. The assessment of global longitudinal strain (GLS) is considered a sensitive marker of left ventricular systolic function. However, it remains unclear whether gender differences exist in GLS and the dynamics of its changes after HTx. Purpose We aimed to investigate whether there are gender differences in GLS among patients after HTx during the 2-year observation period. Methods One hundred patients who underwent HTx between January 2021 and May 2023 were prospectively enrolled in the study. During a 2-year observation period, echocardiographic examinations assessing left ventricle GLS were performed consecutively at 6, 12 and 24 months after HTx, which were followed by routine endomyocardial biopsies (EMB). Exclusion criteria included poor imaging quality (n=3), death within the first 6 months post-transplant (n=21), death during the observation period due to neoplastic disease (n=3), individuals undergoing re-HTx (n=3). Results Two groups were distinguished, consisting of 13 females (mean age 50 IQR:38-58) and 57 male (mean age 54,5, IQR:46-63). There were no significant clinical differences between patients. Arterial hypertension was present in 53,9% of the female group and 44,3% in the male group (p>0,05), while diabetes mellitus constituted 23,1% and 23% respectively (p>0,05). There were also no significant differences in cold ischemia time (157,5 minutes IQR: 118.5- 174.5) vs 129,18 minutes IQR: 97- 162; p = 0,208) or donor age (42 years IQR: 39-46 vs 40 years IQR: 33-48; p = 0,754). In the female group, acute cellular rejection was confirmed in 4 (30.8%) patients, while in the male group in 17 (27.9%) patients. (p =0.558) There was a lack of statistically significant correlations between the gender and the mean value of GLS at 6 (15,3 vs 15,15; p=0,521), 12 (15,7 vs 15,0; p=0,820) and 24 months (17,0 vs 15,20; p=0,884) post-transplant. Conclusion Our findings suggest that there are no significant differences in systolic function assessed by GLS between genders during the 2-year follow-up after orthotopic heart transplantation.