Comparison of Long-Term Survival of Men Versus Women With Heart Failure Treated With Cardiac Resynchronization Therapy
Comparison of Long-Term Survival of Men Versus Women With Heart Failure Treated With Cardiac Resynchronization Therapy
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DOI：
10.1016/j.amjcard.2011.02.345
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发表时间：
2011-07-01
影响因子：
2.8
通讯作者：
Box, Jeroen J.
中科院分区：
文献类型：
--
作者：
Mooyaart, Eline A. Q.;Marsan, Nina Ajmone;Box, Jeroen J.
心脏再同步治疗(CRT)是一种公认的治疗心力衰竭的方法。一些基线特征可以影响CRT的结果，关于性别的影响知之甚少。本研究的目的是阐明CRT术后长期存活率的性别差异。共有578名心力衰竭患者接受CRT治疗。分别于基础状态和CRT后6个月进行临床和超声心动图检查。对男性和女性的全因死亡率进行了比较。研究人群包括431名男性(67岁+/-9岁)和147名女性(65+/-11岁)。临床和超声心动图特征在男性和女性之间没有差异，除了左束支传导阻滞和心力衰竭的非缺血性原因在女性中更常见(分别为81%比68%和63%比33%；p<；0.01)，以及心房颤动在男性中更常见(分别为20%和10%；p=0.01)。在平均34+/-25个月的随访期间，197名患者死亡(158名男性和39名女性)。Kaplan-Meier分析显示，女性和男性的长期存活率有显著差异(p=0.007)。两年全因死亡率男性为15%，女性为8%(p=0.025)。COX比例风险分析显示，女性性别与心力衰竭病因和肾功能一起是长期生存的独立预测因素。特别是，由于非缺血性病因而导致心力衰竭的女性显示出最好的长期存活率。总而言之，女性和非缺血性病因与CRT术后较好的长期存活率独立相关。(C)2011 Elsevier Inc.保留所有权利。(美国心脏杂志2011；108：63-68)
Cardiac resynchronization therapy (CRT) is an established treatment of patients with heart failure. Several baseline characteristics can influence the CRT outcomes, and little is known about the effect of gender. The aim of the present study was to elucidate the gender-related differences in long-term survival after CRT. A total of 578 consecutive patients with heart failure underwent CRT. At baseline and 6 months after CRT, the clinical and echocardiographic parameters were obtained. All-cause mortality was compared between the men and women. The study population included 431 men (67 +/- 9 years) and 147 women (65 +/- 11 years). No differences in the clinical and echocardiographic characteristics were observed between the men and women, except for left bundle branch block and a nonischemic etiology of heart failure, which were more frequent in women (81% vs 68% and 63% vs 33%, respectively; p < 0.01), and atrial fibrillation, which was more prevalent in men (20% vs 10%, respectively; p = 0.01). During a mean follow-up of 34 +/- 25 months, 197 patients died (158 men and 39 women). Kaplan-Meier analysis showed a significant difference in long-term survival between the women and men (p = 0.007). The 2-year all-cause mortality rate was 15% in men and 8% in women (p = 0.025). Cox proportional hazard analysis revealed female gender is an independent predictor of long-term survival, together with heart failure etiology and renal function. In particular, women with heart failure due to a nonischemic etiology showed the best long-term survival rate. In conclusion, female gender and nonischemic etiology were independently associated with better long-term survival after CRT. (C) 2011 Elsevier Inc. All rights reserved. (Am J Cardiol 2011;108:63-68)