{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T11:24:58Z","timestamp":1740137098979,"version":"3.37.3"},"reference-count":39,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,2,20]],"date-time":"2018-02-20T00:00:00Z","timestamp":1519084800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Female sex is a risk factor for thromboembolism (<jats:styled-content style=\"fixed-case\">TE<\/jats:styled-content>) in atrial fibrillation (<jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>); however, the underlying mechanisms are unclear. We postulated that left ventricular (<jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content>) diastolic dysfunction (<jats:styled-content style=\"fixed-case\">LVDD<\/jats:styled-content>) could be associated with increased thromboembolic risk in women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From a retrospective cohort, 158 patients (female\u00a0:\u00a0male\u00a0=\u00a079:79) with nonvalvular <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content> were propensity score\u2010matched for age, presence of diabetes, hypertension, coronary artery disease, congestive heart failure, embolic history, <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content> type, and <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content> duration. Cardiac size and function and central aortic stiffness parameters were evaluated. Diastolic function was classified as normal, indeterminate, and <jats:styled-content style=\"fixed-case\">LVDD<\/jats:styled-content> according to recent guidelines. Surrogate markers for thromboembolism (dense spontaneous echo contrast and thrombus) were evaluated using transesophageal echocardiography.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Surrogate markers for <jats:styled-content style=\"fixed-case\">TE<\/jats:styled-content> showed a trend to be more frequent in women than in men (21.5% vs 11.4%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.086). <jats:styled-content style=\"fixed-case\">LVDD<\/jats:styled-content> was more prevalent in women than in men (22.8% vs 2.5%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001); however, the prevalence of indeterminate diastolic function was not different between sexes (26.6% vs 20.3%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.453). Surrogate markers for <jats:styled-content style=\"fixed-case\">TE<\/jats:styled-content> were detected mostly in women with <jats:styled-content style=\"fixed-case\">LVDD<\/jats:styled-content>. <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content> diastolic parameters showed a restrictive pattern, and aortic stiffness parameters were worse in women than in men. Women with <jats:styled-content style=\"fixed-case\">LVDD<\/jats:styled-content> had increased aortic stiffness compared to women with indeterminate and normal function, whereas aortic stiffness did not differ among men in all groups. Significant relations between <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content> diastolic function and aortic stiffness parameters were observed only in women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">LVDD<\/jats:styled-content> due to increased aortic stiffness could be related to a higher thromboembolic risk in women with <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.13843","type":"journal-article","created":{"date-parts":[[2018,2,21]],"date-time":"2018-02-21T18:57:30Z","timestamp":1519239450000},"page":"817-826","source":"Crossref","is-referenced-by-count":1,"title":["Evaluation of sex differences in the relationship between diastolic dysfunction and thromboembolism using propensity score 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University Anam Hospital  Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2467-3336","authenticated-orcid":false,"given":"Wan Joo","family":"Shim","sequence":"additional","affiliation":[{"name":"Division of Cardiology Korea University Anam Hospital  Seoul 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