COMPARISON OF CLINICAL FINDINGS IN IDIOPATHIC DILATED CARDIOMYOPATHY IN WOMEN VERSUS MEN
COMPARISON OF CLINICAL FINDINGS IN IDIOPATHIC DILATED CARDIOMYOPATHY IN WOMEN VERSUS MEN
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DOI：
10.1016/0002-9149(93)90355-g
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发表时间：
1993-09-01
影响因子：
2.8
通讯作者：
CAMERINI, F
中科院分区：
文献类型：
--
作者：
DEMARIA, R;GAVAZZI, A;CAMERINI, F
比较了65名女性和238名男性侵袭性记录的特发性扩张型心肌病的临床和实验室结果。女性有更严重的症状(纽约心脏协会分级大于或等于III级的48人比39%；p<；0.05)，出现心力衰竭体征的频率更高(63vs41%；p<；0.01)，有更高的心胸比率(0.56+/-0.06vs0.53+/-0.06；p<；0.05)和更高的左束支传导阻滞频率(41vs29%；p<；0.05)。超声心动图显示女性左心室舒张期(42+/-7vs39+/-6 mm/m2；p<；0.0001)和收缩末期(36+/-7vs33+/-6 mm/m2；p<；0.001)直径显著增大，平均心肌厚度(11+/-2vs10+/-2 mm；p<；0.05)。女性的锻炼时间比男性短(7+/-3分钟比10+/-4分钟；p<；0.001)。18+/-16个月后，9名女性和27名男性死亡，分别有7名和17名接受了移植。无移植存活率在不同性别之间没有显著差异。经COX多因素分析，在男性和女性中，左心室射血分数(P<；0.005)、左心房直径指数(P<；0.01)和平均肺动脉压(P<；0.01)是心源性死亡或心脏移植的显著独立预测因子。
Clinical and laboratory findings were compared in 65 women and 238 men with invasively documented idiopathic dilated cardiomyopathy. Women had more severe symptoms (New York Heart Association class greater-than-or-equal-to III in 48 vs 39%; p < 0.05), presented more frequently with heart failure signs (63 vs 41%; p < 0.01), and had a higher cardiothoracic ratio (0.56 +/- 0.06 vs 0.53 +/- 0.06; p < 0.05) and higher frequency of left bundle branch block (41 vs 29%; p < 0.05). Echocardiographic measurements in women showed significantly greater left ventricular (LV) end-diastolic (42 +/- 7 vs 39 +/- 6 mm/m2; p < 0.0001) and end-systolic (36 +/- 7 vs 33 +/- 6 mm/m2; p < 0.001) diameters, and mean myocardial thickness (11 +/- 2 vs 10 +/- 2 mm; p < 0.05). Exercise duration was shorter in women than in men (7 +/-3 vs 10 +/- 4 minutes; p < 0.001). After 18 +/- 16 months, 9 women and 27 men died, and 7 and 17, respectively, received transplants. Transplant-free survival was not significantly different according to gender. By Cox multivariate analysis, LV ejection fraction was a significant independent predictor of cardiac death or heart transplantation in both sexes (p < 0.05) in men, and p < 0.005 in women), together with left atrial diameter index (p < 0.01) in women, and mean pulmonary artery pressure (p