在两个独立的队列中,对HFpEF的临床诊断算法的性别特异性性能
Xinyu Li1, Anouk Achten1, Soufiane Nassiri2
1Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands.
概括
通过保留喷射分数 (HFpEF) 诊断心力衰竭是一项挑战. 目前的诊断算法可能在女性中表现更好,比男性更好,这表明需要针对性别进行优化.
科学领域:
- 心脏病学 心脏病学
- 医学诊断 医学诊断 医学诊断
- 医学中的性别差异.
背景情况:
- 通过保留喷射分数 (HFpEF) 诊断心力衰竭存在重大挑战.
- 现有的HFpEF诊断算法尚未对性别特异性性能进行充分评估.
- HFpEF在女性中更为普遍,引发了对潜在的基于性别的不足诊断的担忧.
研究的目的:
- 为了评估三个HFpEF算法的诊断准确性:HFA-PEFF,H2FPEF和ESC HF 2016标准.
- 调查这些HFpEF诊断算法的性能中与性别相关的潜在差异.
主要方法:
- 分析了两个有着不明原因呼吸障碍的前景群体 (阿姆斯特丹和马斯特里赫特).
- 使用右心导管术 (RHC) 确认或排除HFpEF诊断或使用HFpEF得分的专家共识.
- 通过ROC曲线,AUC和规则入选/排除指标评估性别特定的诊断性能.
主要成果:
- HFpEF的患病率很高 (84.4%和82.5%),两个群体中的女性占多数.
- 在所有算法中,男性的AUC值始终低于女性,尽管在统计学上并不显著.
- 在阿姆斯特丹队列中,H2FPEF显示出最高的诊断性能,而HFA-PEFF在马斯特里赫特队列中领先,男性的数值表现较低.
结论:
- 当前的HFpEF诊断算法可能在门诊环境中表现出女性的表现优于男性.
- 在性别之间的算法性能中观察到的不一致性凸显了为准确的HFpEF诊断需要进一步的细化和优化.
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