在患有心房的患者心房基质的性别相关差异
Olivier Van Leuven1, Marco Bergonti2, Francesco Raffaele Spera1
1Departments of Cardiology, University Hospital Antwerp, Antwerp, Belgium.
The American journal of cardiology
|August 4, 2023
概括
女性在心房中表现出较大的低压区 (LVZ),表明心房更广泛的重塑. 尽管如此,肺静脉隔离 (PVI) 后心房的复发率在性别之间相似,LVZ具有不同的预后作用.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 前庭的研究研究.
背景情况:
- 在肺静脉隔离 (PVI) 治疗心房动 (AF) 后的结局中,已知存在与性别相关的差异.
- 前庭基质显著影响了废除结果,但尚未对前庭基质的详细性别特异性差异进行探索.
- 低压区 (LVZs) 代表着心房重塑和纤维化区域,对于理解AF病理生理学至关重要.
研究的目的:
- 在PVI之前调查心房重塑的性别相关差异,特别是自发低压区 (LVZs).
- 分析这些性别特异性LVZ对PVI后AF复发的临床相关性和预后影响.
主要方法:
- 一项前性多中心研究,涉及连续接受首次PVI-only AF切除术的患者.
- 使用多极导管进行高密度电解剖绘图,用于在PVI之前分析LVZ.
- 进行了28个月的随访,以评估AF无复发生存率.
主要成果:
- 与男性相比,女性的LVZ显著增加 (10%与左心房表面的4%相比).
- 女性的性别独立地与四倍高的晚期心房重塑风险相关 (LVZ>15%).
- 无复发AF存活率在性别之间没有差异,但LVZ与更高的AF复发率独立相关 (HR1.2,p=0.038).
结论:
- 女性在所有左心房区域都表现出更广泛的LVZ,这表明心房重塑更大.
- 尽管进行了更广泛的改造,但AF复发率在PVI后的男性和女性中相似.
- 根据性别,LVZ的预后意义不同,仅在较高负担 (>15%) 时才成为预测女性结果的相关因素.
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