Sex-Specific Associations of Risks and Cardiac Structure and Function With Microalbumin/Creatinine Ratio in Diastolic Heart Failure.
Sex-Specific Associations of Risks and Cardiac Structure and Function With Microalbumin/Creatinine Ratio in Diastolic Heart Failure.
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舒张性心力衰竭中风险、心脏结构和功能与微量白蛋白/肌酐比值的性别特异性关联。
DOI：
10.3389/fcvm.2020.579400
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发表时间：
2020
影响因子：
3.6
通讯作者：
Liu C
中科院分区：
文献类型：
--
作者：
Wei FF;Xue R;Wu Y;Liang W;He X;Zhou Y;Owusu-Agyeman M;Wu Z;Zhu W;He J;Staessen JA;Dong Y;Liu C
背景：射血分数保留性心力衰竭（HFpEF）女性患者多于男性。然而，关于HFpEF患者的不良健康结局与左心室结构和功能以及微量白蛋白尿的性别特异性相关性的数据很少。研究方法：在1，334名参加醛固酮拮抗剂治疗保留心功能心力衰竭（TOPCAT）试验的受试者中，我们使用考克斯或线性回归估计了性别特异性多变量校正风险和尿微量白蛋白/肌酸比值（ACR）的LV特征。结果：共有604名（45.3%）为女性。在多变量校正分析中，男性和女性ACR加倍与较高的后验相关性。（+0.014 cm，p = 0.012/+0.012 cm，p = 0.033）室壁厚度和左心室质量指数（+2.55 mg/m2，p = 0.004/+2.45 mg/m2，p = 0.009），而与高间隔（+0.018 cm，p = 0.002）和左心房容积指数（+1.44 mL/m2，p = 0.001）。ACR是所有原因的关键预测因子（HR，1.11; p = 0.006）和心血管（HR，1.17; p = 0.002）女性死亡，而男性ACR与HF住院相关（HR，1.23; p < 0.001）、任何住院（HR，1.06; p = 0.006）和心肌梗死（HR，1.19; p = 0.017）。对于因心力衰竭住院和任何住院，性别与ACR的相互作用具有显著性（p ≤ 0.034）。结论：HFpEF患者的结局以及心脏结构和功能似乎受到ACR的影响，并因性别而异。在男性中，ACR与LV舒张功能、住院和心肌梗死显著相关，而在女性中与死亡率相关。
Background: Heart failure with preserved ejection fraction (HFpEF) affects women more frequently than men. However, data on sex-specific associations of adverse health outcomes and left ventricular structure and function and with microalbuminuria in patients with HFpEF are scarce. Methods: In 1,334 participants enrolled in the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) Trial, we estimated the sex-specific multivariable-adjusted risk and LV traits with urine microalbumin/creatine ratio (ACR), using Cox or linear regression. Results: In total, 604 (45.3%) were women. In multivariable-adjusted analyses, a doubling of ACR in both men and women was associated with higher posterior (+0.014 cm, p = 0.012/+0.012 cm, p = 0.033) wall thickness and left ventricular mass index (+2.55 mg/m2, p = 0.004/+2.45 mg/m2, p = 0.009), whereas was also associated with higher septal (+0.018 cm, p = 0.002) and left atrial volume index (+1.44 mL/m2, p = 0.001) in men. ACR was a key predictor of all-cause (HR, 1.11; p = 0.006) and cardiovascular (HR, 1.17; p = 0.002) death in women, whereas in men ACR was associated with HF hospitalization (HR, 1.23; p < 0.001), any hospitalization (HR, 1.06; p = 0.006), and myocardial infarction (HR, 1.19; p = 0.017). The interactions of sex with ACR were significant for hospitalization for heart failure and any hospitalization (p ≤ 0.034). Conclusions: Outcomes and cardiac structure and function in patients with HFpEF appear to be influenced by ACR that vary according to sex. In men, ACR was significant associated with LV diastolic function, hospitalization, and myocardial infarction, whereas in women was associated with mortality.
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影响因子：
49.6
作者：
Bui, Anh L.;Horwich, Tamara B.;Fonarow, Gregg C.
通讯作者：
Fonarow, Gregg C.
影响因子：
9.7
作者：
Shah, Amil M.;Claggett, Brian;Solomon, Scott D.
通讯作者：
Solomon, Scott D.
影响因子：
37.8
作者：
Peters, Sanne A. E.;Muntner, Paul;Woodward, Mark
通讯作者：
Woodward, Mark
影响因子：
37.8
作者：
Cheng S;Xanthakis V;Sullivan LM;Lieb W;Massaro J;Aragam J;Benjamin EJ;Vasan RS
通讯作者：
Vasan RS
影响因子：
158.5
作者：
Pitt, Bertram;Pfeffer, Marc A.;McKinlay, Sonja M.
通讯作者：
McKinlay, Sonja M.