Transgender Women Exhibit a Distinct Stress Echocardiography Profile Compared to Age-Matched Cisgender Counterparts: The Mayo Clinic Women's Heart Clinic Experience

Transgender Women Exhibit a Distinct Stress Echocardiography Profile Compared to Age-Matched Cisgender Counterparts: The Mayo Clinic Women's Heart Clinic Experience

Stress echocardiography (SE) is an important modality in cardiovascular risk stratification and obstructive coronary artery disease (CAD) assessment. Binary sex-based parameters are classically used for interpretation of these studies, even among transgender women (TGW). CAD is a leading cause of mo...

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Veröffentlicht in:Journal of the American Society of Echocardiography 2024-05
Hauptverfasser: Adel, Fadi, Walsh, Connor D, Bretzman, John, Sang, Philip, Lara-Breitinger, Kyla, Mahowald, Madeline, Maheshwari, Arvind, Scott, Christopher G, Lee, Alexander T, Davidge-Pitts, Caroline J, Pellikka, Patricia A, Mankad, Rekha
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container_title Journal of the American Society of Echocardiography
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creator Adel, Fadi
Walsh, Connor D
Bretzman, John
Sang, Philip
Lara-Breitinger, Kyla
Mahowald, Madeline
Maheshwari, Arvind
Scott, Christopher G
Lee, Alexander T
Davidge-Pitts, Caroline J
Pellikka, Patricia A
Mankad, Rekha
description Stress echocardiography (SE) is an important modality in cardiovascular risk stratification and obstructive coronary artery disease (CAD) assessment. Binary sex-based parameters are classically used for interpretation of these studies, even among transgender women (TGW). CAD is a leading cause of morbidity and mortality in this population. Yet, it remains unclear whether TGW exhibit a distinct stress testing profile from their cisgender counterparts. Using a matched case-control study design, we compared the echocardiographic stress testing profiles of TGW (n=43) with those of matched cisgender men (CGM, n=84) and cisgender women (CGW, n=86) at a single center. Relevant data, including demographics, comorbidities, and cardiac testing data were manually extracted from the patients' charts. The prevalence of hypertension and dyslipidemia was similar between TGW and CGW and lower than that of CGM (p= .003 and .009, respectively). The majority of comorbidities and lab values were similar. On average, TGW had higher heart rates than CGM (p=.002) and had lower blood pressures than CGM and CGW (p
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Binary sex-based parameters are classically used for interpretation of these studies, even among transgender women (TGW). CAD is a leading cause of morbidity and mortality in this population. Yet, it remains unclear whether TGW exhibit a distinct stress testing profile from their cisgender counterparts. Using a matched case-control study design, we compared the echocardiographic stress testing profiles of TGW (n=43) with those of matched cisgender men (CGM, n=84) and cisgender women (CGW, n=86) at a single center. Relevant data, including demographics, comorbidities, and cardiac testing data were manually extracted from the patients' charts. The prevalence of hypertension and dyslipidemia was similar between TGW and CGW and lower than that of CGM (p= .003 and .009, respectively). The majority of comorbidities and lab values were similar. On average, TGW had higher heart rates than CGM (p=.002) and had lower blood pressures than CGM and CGW (p&lt;.05). The TGW's double product and metabolic equivalents were similar to those among CGW and lower than those of CGM (p=.016, p=.018, respectively). On echocardiography, the left ventricular end-diastolic and end-systolic diameters among TGW were similar to those of CGW but lower than CGM's (p=.023, p=.018, respectively). Measures of systolic and diastolic function, except for the exercise mitral valve E:e' ratio which was lower in TGW than CGW (p=.029), were largely similar among the three groups. There was no difference in the wall motion score index, and therefore, no difference in the percentage of positive SE tests. Our study shows, for the first time, that TGW have a SE profile that is distinct from that of their cisgender counterparts. 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title Transgender Women Exhibit a Distinct Stress Echocardiography Profile Compared to Age-Matched Cisgender Counterparts: The Mayo Clinic Women's Heart Clinic Experience
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