Eur Heart J:肥厚性心肌病女性患者的生存率更差

2017-09-09 xiangting MedSci原创

由于HCM女性的生存率更差,性别是HCM管理中的重要决定因素。

肥厚性心肌病(HCM)的性别差异尚不清楚。这项研究试图描述一个大型HCM转诊中心人群中的性别差异。

3673名HCM成人患者于1975年1月至2012年9月期间进行了评估,其中女性1661人(45.2%)。通过时序检验评估Kaplan-Meier生存率曲线。Cox比例风险回归分析评估了性别与生存率的关系。女性的年龄较大(59±16岁vs 52±15岁,P<0.0001),有更多症状[纽约心脏协会(NYHA)III-IV级45.0%vs.35.3%,P<0.0001],更多的阻塞性生理(77.4%vs. 71.8%,P= 0.0001),更多的二尖瓣反流(中度或更高56.1%vs.43.9%,P<0.0001),E/e比更高(n= 1649,20.6 vs.15.6 ,P<0.0001),较高的估算肺动脉收缩压(n= 1783,40.8±15.4vs.比34.8±10.8 mmHg,P<0.0001),更差的心肺运动功能(n= 1267;VO2预测值%62.8±20%vs.65.8±19.2%,P= 0.007),更多的酒精隔膜消融(4.9%vs. 3.0%,P= 0.004),但切除率相似(28%vs.30%,P= 0.24)。中位随访为10.9年(IQR 7.4-16.2)。Kaplan-Meier分析显示女性与男性相比,其生存率较低(P 血管并发症调整后,女性性别与死亡率(HR 1.13 [1.03-1.22],P = 0.01)独立相关。

女性HCM患者比男性的年龄更大、症状更多、心肺运动耐力更差、血液动力学也不同。因为HCM女性的生存率更差,性别是HCM管理中的重要决定因素。女性可能需要更积极的诊断和治疗方式。

原始出处:
Jeffrey B. Geske, et al. Women with hypertrophic cardiomyopathy have worse survival. Eur Heart J. 7 September 2017. 

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    2017-09-11 zhaojie88
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    2017-09-11 slcumt
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