心肌重塑中的性别差异和大动脉吐中的细胞外体积
Maan Malahfji1, Alpana Senapati1, Dany Debs1
1Cardiovascular MRI Laboratory, Division of Cardiovascular Imaging, Houston Methodist DeBakey Heart & Vascular Center, 6550 Fannin Street, Smith Tower - Suite 1801, Houston, TX, 77030, USA.
Scientific reports
|July 13, 2023
概括
由于大动脉反 (AR) 的心脏重塑中的性别差异尚不清楚. 与男性不同,女性的左心室 (LV) 体积较小,但细胞外体积 (ECV) 增加,反更高,表明明显的AR进展.
科学领域:
- 心血管成像和诊断系统
- 心脏重塑和病理生理学
- 心血管疾病的性别差异
背景情况:
- 与大动脉吐 (AR) 相关的心脏重塑中性别特异性的存在仍然在很大程度上未确定.
- 心脏磁共振 (CMR) 是对心脏重塑和组织特征的非侵入性评估的黄金标准.
研究的目的:
- 通过使用心脏磁共振 (CMR) 来研究大动脉吐患者心脏重塑中的潜在性别差异.
- 评估AR严重程度与组织特征之间的关系,特别是男性和女性的细胞外体积 (ECV).
主要方法:
- 一项前性队列研究,包括280名AR患者 (109名女性) 在2011年至2020年期间接受CMR治疗.
- 量化左心室 (LV) 体积,质量,AR严重程度,替代纤维化 (晚期加多利尼姆增强 - LGE) 和细胞外体积分数 (ECV).
- 根据身体表面积调整的统计分析,以比较重塑参数中的性别差异及其与AR严重程度的关联.
主要成果:
- 在所有AR严重程度上,女性的绝对LV体积和质量比男性要小.
- 在按人体表面积进行索引后,没有观察到LV终端透缩体积和质量的显著差异,但男性的LV终端透缩体积较大,射出分数较低.
- 增加的反体积 (RVol) 独立地与女性的ECV增加有关 (P的相互作用=0.03),但在男性中没有,这表明性别特异的间歇扩张.
结论:
- 虽然女性表现出较低的LV体积和质量,但与男性不同的是,她们的细胞外体积随着AR严重程度的增加而扩大,这表明不同的重塑途径.
- 身体表面积索引没有完全调和基于性别的心脏重塑差异.
- 需要进一步的研究来确定这些ECV差异是否会影响AR进展和临床结果.
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