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Gender difference in clinical and genetic characteristics of Brugada syndrome: SADS-TW BrS registry

C-Y J Chen1, J-M J Juang1, L-Y Lin1

  • 1Cardiovascular Center and Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.

QJM : Monthly Journal of the Association of Physicians
|January 29, 2019
PubMed

Insights

Brugada syndrome (BrS) shows gender differences. Females experience syncope earlier and have longer QTc intervals, while males with sudden cardiac death (SCD) have longer QRS duration and QTc. SCN5A mutation rates were similar between genders.

Area of Science:

  • Cardiology
  • Genetics
  • Clinical Medicine

Background:

  • Brugada syndrome (BrS) is an inherited condition causing sudden cardiac death (SCD), predominantly affecting males.
  • Limited data exists on gender-specific differences in BrS.

Purpose of the Study:

  • To investigate gender disparities in Brugada syndrome among the Han Chinese population.
  • To compare clinical characteristics, electrocardiographic parameters, and SCN5A mutation status between male and female BrS patients.

Main Methods:

  • A cohort of 169 Han Chinese BrS patients (153 males, 16 females) in Taiwan was studied between 1998 and 2017.
  • Comparative analysis of clinical data, ECG parameters (QTc, QRS duration, PR interval, heart rate), and SCN5A mutation status between genders.

Main Results:

  • Females presented with a trend towards higher family history of SCD (31.3% vs. 15%) and significantly longer QTc intervals (457.8 ± 33.0 ms vs. 429.5 ± 42.1 ms).
  • Females experienced their first cardiac events (SCD or syncope) at an earlier age than males (P=0.049), primarily due to syncope.
  • Males with SCD showed longer QRS duration (114.2 ± 26.8 ms vs. 104.8 ± 15.3 ms) and QTc (442.5 ± 57.4 ms vs. 422.9 ± 28.8 ms). Males with syncope had longer PR intervals (181.2 ± 33.7 ms vs. 165.7 ± 27.1 ms).

Conclusions:

  • Significant gender differences exist in Brugada syndrome presentation and risk factors.
  • Females with BrS exhibit longer QTc and earlier onset of syncope. Males with SCD are associated with broader QRS and longer QTc, while syncope risk in males is linked to longer PR intervals.
  • No significant difference in SCN5A mutation prevalence was observed between genders, suggesting other factors contribute to gender-specific BrS manifestations.
Abstract

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