The Renal Effects of Low-Dose Dopamine Infusion in Elderly Patients Hospitalized for Acute Decompensated Heart Failure

Background: Prior studies have shown that women admitted with acutely decompensated heart failure have higher left ventricular ejection fractions (LVEF) than their male counterparts. In this study, we sought to determine if other echocardiographic differences exist between men and women hospitalized with ADHF and if gender is predictive of hospital length of stay (LOS), readmission and mortality. Methods: We retrospectively studied 182 consecutive patients admitted with ADHF to a tertiary teaching hospital. Echocardiographic variables were recorded (blinded to gender) in addition to clinical characteristics and 6-month outcomes. Results: Compared to men, women had higher mean LVEF, smaller LVs and left atria (LA), thinner LV posterior wall thickness, higher transmitral E and A velocities, and less right ventricular (RV) systolic dysfunction. In contrast, the degree of mitral (MR) and tricuspid regurgitation (TR) and RV systolic pressure (RVSP) were similar in both sexes, as were hospital LOS, and readmission and death at six months. Continuous and categorical variables were analyzed using student’s t-test and chisquared test respectively. Conclusions: LOS and 6 month outcomes are similar in women and men despite the presence of a higher LVEF and less RV systolic dysfunction in women, suggesting that other parameters, probably affecting diastolic function, play a greater role in women and should be targeted in an attempt to improve clinical outcomes.