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Muerte cardíaca súbita en mujeres
M Anette E Haukilahti1, Lauri Holmström1, Juha Vähätalo1
1From Research Unit of Internal Medicine (M.A.E.H., L.H., J.V., T.K., J.T., J.P., H.H., M.J.J.), Medical Research Center Oulu, University of Oulu and University Hospital of Oulu, Finland.
Circulation
|February 20, 2019
Resumen
La muerte súbita cardíaca (SCD) en las mujeres a menudo ocurre a edades mayores y tiene causas no isquémicas. Si bien las mujeres con SCD pueden tener ECGs normales, también muestran más marcadores de hipertrofia ventricular izquierda, lo que indica factores de riesgo complejos.
Área de la Ciencia:
- Cardiología
- Patología
- Investigaciones médicas
Sus antecedentes:
- La muerte súbita cardíaca (SCD) sigue siendo una causa importante de mortalidad a pesar de los avances en el tratamiento de las enfermedades cardíacas.
- La elaboración de perfiles de riesgo y las estrategias de prevención para la ECS están menos definidas en las mujeres que en los hombres.
- La comprensión de los mecanismos específicos del sexo y los marcadores de riesgo para la enfermedad de la cadera es crucial para mejorar los resultados.
Objetivo del estudio:
- Investigar los hallazgos de la autopsia y las causas de muerte en una gran población de mujeres que experimentan SCD.
- Comparar las características de la SCD entre sujetos femeninos y masculinos.
- Analizar y clasificar los hallazgos previos del electrocardiograma (ECG) en relación con la SCD en ambos sexos.
Principales métodos:
- Se utilizaron datos del estudio Fingesture, una colección completa de datos clínicos y de autopsia de 1998-2017 en el norte de Finlandia.
- Se analizaron datos de 5869 sujetos que experimentaron SCD, con un enfoque en 1101 individuos (25,3% de mujeres) con ECG disponibles.
- Comparación de datos demográficos, de autopsia y de ECG entre las cohortes masculinas y femeninas de SCD.
Principales resultados:
- Los sujetos femeninos de ECS eran mayores (70,1 años) que los varones (63,5 años).
- La enfermedad cardíaca isquémica fue la principal causa de muerte en ambos sexos, pero las causas no isquémicas fueron más frecuentes en las mujeres (28,3% frente a 24,3%).
- Las mujeres mostraron tasas más altas de fibrosis miocárdica y ECG anteriores normales, pero también exhibieron más marcadores de ECG para la hipertrofia ventricular izquierda.
Conclusiones:
- Las mujeres experimentan SCD a edades mayores y con una mayor probabilidad de etiologías no isquémicas.
- La prevalencia de la fibrosis miocárdica es notablemente mayor en las mujeres con SCD.
- Si bien las mujeres con SCD pueden presentar ECGs normales, las anormalidades específicas de hipertrofia y repolarización son más comunes, lo que sugiere perfiles de riesgo distintos.
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