在心力衰竭患者中右心室功能障碍:性是否重要?
Carolina Guimaraes1, Rita Gouveia1, Helena Hipólito-Reis1
1Internal Medicine Department, São João Local Health Unit, Porto, Portugal.
The American journal of cardiology
|March 31, 2025
概括
右心室功能障碍 (RVD) 恶化了心力衰竭 (HF) 的存活率. 这种负面预后影响仅在女性患者中观察到,而不是男性患者中,这表明性别影响慢性HF的RVD结果.
科学领域:
- 心脏病学 心脏病学
- 心脏衰竭研究研究
- 医学中的性别差异.
背景情况:
- 右心室功能障碍 (RVD) 是慢性心力衰竭 (HF) 患者生存率低下的已知预测因素.
- 现有研究表明,在RVD中存在潜在的性别差异,但这些差异仍未得到充分研究.
- 了解这些差异对于个性化高频管理至关重要.
研究的目的:
- 调查性别对慢性静心性心力衰竭 (HF) 患者RVD预后影响的影响.
- 为了确定RVD是否对男性和女性HF患者具有相同的生存影响.
主要方法:
- 对1,152名患有左心室缩功能障碍 (LVSD) 的成年门诊慢性HF患者的回顾性分析.
- 从2012年1月到2020年12月收集的数据,后续调查至2023年1月.
- 考克斯回归分析用于评估RVD的预后影响,并对混因子进行调整,并对性别进行相互作用测试.
主要成果:
- 右心室功能障碍 (RVD) 在17%的患者中存在,并与较高的全因死亡率相关 (aHR=1.86).
- 分层分析显示,RVD的负预后影响仅在女性患者中显著 (aHR=1.56).
- 在男性HF患者中没有发现RVD和死亡率之间的显著预后关联;性别和RVD之间的相互作用是显著的 (p=0.03).
结论:
- 右心室功能障碍 (RVD) 与显著更糟糕的结果仅在女性慢性静心性心力衰竭 (HF) 患者中相关.
- 患有RVD的女性HF患者与没有RVD的患者相比,死亡风险增加了56%.
- 这些发现强调,性别显著影响慢性HF中RVD的预后影响,强调需要性别特定的治疗策略.
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