怀疑心肌炎表现和结果的性别特异性差异
Jonathan Schütze1, Noah Greisser1, Philippe Joss1
1Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland.
International journal of cardiology
|September 27, 2024
概括
心肌炎的表现和结果在两性之间存在差异. 患有心肌炎的女性面临心力衰竭住院的风险增加了一倍,这凸显了在管理这种心血管疾病时需要按性别分类风险分层的需要.
科学领域:
- 心脏病学 心脏病学
- 临床医学 临床医学
- 基于性别的医学
背景情况:
- 心肌炎,心肌的炎症,在男性和女性之间呈现出各种迹象和症状.
- 了解这些性别差异对于准确的诊断和管理至关重要.
研究的目的:
- 调查和比较性差异的临床表现,心磁共振 (CMR) 发现,和怀疑心肌炎的患者的结果.
- 确定性别是否影响重大心血管不良事件 (MACE) 和心力衰竭住院的风险.
主要方法:
- 分析了来自两个三级中心 (2002-2021) 怀疑心肌炎的776名符合ESC标准的患者队列.
- 基线特征,CMR数据,以及包括MACE (全因死亡,心室动脉冲动,心力衰竭住院治疗,复发性心肌炎) 在内的结果在性别之间进行了比较.
- 进行了统计分析,以确定与结果的性别相关联.
主要成果:
- 妇女更频繁地出现严重呼吸不全 (NYHA III-IV),而男性则报告更多的胸痛.
- 在呈现时,两性之间没有观察到左心室喷射率的显著差异.
- 虽然整体MACE的发病率相似,但女性心力衰竭住院率明显高 (9.8%对5.3%).
结论:
- 在疑似心肌炎的呈现和成像发现中存在显著的性别差异.
- 女性性别独立地与心力衰竭住院的风险增加两倍有关.
- 这些发现强调了在心肌炎患者的风险分层和管理策略中考虑性别的重要性.
相关概念视频
Myocarditis II: Clinical features and Diagnostic Tests
2
Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...
2
Myocarditis I: Introduction
2
Myocarditis is inflammation of the myocardium, which is the muscular layer of the heart.EtiologyMyocarditis has a diverse etiology, including a wide range of infectious and non-infectious causes:Infectious CausesViral: Common viruses include Coxsackie A and B, adenovirus, parvovirus B19, enteroviruses, and influenza A.Bacterial: Examples include infections caused by Streptococcus, Staphylococcus, and Mycoplasma species.Rickettsial: Infections like Rocky Mountain spotted fever can result in...
2
Myocarditis III: Medical Management
2
Myocarditis: Comprehensive Medical ManagementMyocarditis, the heart muscle inflammation, requires a comprehensive medical management strategy that addresses the underlying cause, provides supportive care, manages symptoms, and reduces cardiac workload.Infections and Autoimmune CausesAdminister appropriate antimicrobial therapy when an infectious agent causes myocarditis. For instance, penicillin treats infections caused by Group A Streptococcus. In cases where autoimmune processes are...
2
Myocarditis IV: Nursing Management
2
Myocarditis is an inflammatory condition of the myocardium requiring meticulous nursing management for optimal patient outcomes. Effective management begins with a thorough assessment of the patient's medical history, paying close attention to past infections, autoimmune disorders, travel history, and exposure to toxins or drugs. Recent viral infections and systemic diseases are particularly relevant due to their potential role in triggering myocarditis.Physical Examination and MonitoringThe...
2
Endocarditis II: Clinical features and Diagnostic Tests
2
Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
2
Pericarditis II: Clinical features and Diagnostic Tests
3
Pericarditis is distinguished by inflammation of the pericardium, the fibrous sac that encases the heart. It can be acute, lasting less than six weeks, or chronic, persisting for over three months. Understanding its clinical manifestations and diagnostic findings is crucial for timely and effective management.Clinical ManifestationsWhile pericarditis can be asymptomatic, it usually presents with characteristic symptoms such as:Chest Pain: The most characteristic symptom of pericarditis is chest...
3


