Poorer Right Ventricular Systolic Function and Exercise Capacity in Women After Repair of Tetralogy of Fallot: A Sex Comparison of Standard Deviation Scores Based on Sex-Specific Reference Values in Healthy Control Subjects
Poorer Right Ventricular Systolic Function and Exercise Capacity in Women After Repair of Tetralogy of Fallot: A Sex Comparison of Standard Deviation Scores Based on Sex-Specific Reference Values in Healthy Control Subjects
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法洛四联症修复后女性右心室收缩功能和运动能力较差：基于健康对照受试者特定性别参考值的标准差评分的性别比较
DOI：
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发表时间：
2013
期刊：
影响因子：
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通讯作者：
P. Beerbaum
中科院分区：
文献类型：
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作者：
S. Sarikouch;D. Boethig;B. Peters;S. Kropf;K. Dubowy;P. Lange;T. Kuehne;A. Haverich;P. Beerbaum
背景——在修复型先天性心脏病中，越来越多的证据表明心脏重塑存在性别差异，但缺乏特定先天性心脏病缺陷（例如法洛四联症修复型）的可比数据。方法和结果——在一项前瞻性多中心研究中，对 272 名当代法洛四联症修复患者（158 名男性；平均年龄，14.3±3.3 岁[范围，8-20 岁]）进行了心脏磁共振检查，以检测心室功能和代谢运动测试。根据 Lambda-Mu-Sigma 方法，通过将特定性别的健康对照受试者的个体值与其各自的第 50 个百分位（标准差得分，0）相关联，将所有数据转换为标准差得分。在修复年龄、修复类型或总体血流动力学结果方面未观察到性别差异。相对于特定性别的对照组，女性法洛四联症修复术后右心室收缩末期容积较大（标准差评分：女性，4.35；男性，3.25；P=0.001），右心室射血分数较低（女性，-2.83；男性，-2.12；P=0.011），右心室肌质量较低（女性，1.58；男性，2.45； P=0.001），峰值摄氧量较差（女性，-1.65；男性，-1.14；P<0.001），较高的VE/VCO2（每单位二氧化碳产生的通气量）斜率（女性，0.88；男性0.58；P=0.012），峰值心率降低（女性，-2.16；男性-1.74； P=0.017）。左心室参数在性别之间没有差异。结论——相对于各自性别特定的健康对照受试者，法洛四联症修复后得出的标准差评分表明，通过心脏磁共振和运动能力测试，女性在右心室收缩功能方面表现较差。这种效应不能用选择偏差来解释。需要来自纵向队列研究的进一步结果数据。临床试验注册——URL：http://www.clinicaltrials.gov。唯一标识符：NCT00266188。
Background—In repaired congenital heart disease, there is increasing evidence of sex differences in cardiac remodeling, but there is a lack of comparable data for specific congenital heart defects such as in repaired tetralogy of Fallot. Methods and Results—In a prospective multicenter study, a cohort of 272 contemporary patients (158 men; mean age, 14.3±3.3 years [range, 8–20 years]) with repaired tetralogy of Fallot underwent cardiac magnetic resonance for ventricular function and metabolic exercise testing. All data were transformed to standard deviation scores according to the Lambda–Mu–Sigma method by relating individual values to their respective 50th percentile (standard deviation score, 0) in sex-specific healthy control subjects. No sex differences were observed in age at repair, type of repair conducted, or overall hemodynamic results. Relative to sex-specific controls, repaired tetralogy of Fallot in women had larger right ventricular end-systolic volumes (standard deviation scores: women, 4.35; men, 3.25; P=0.001), lower right ventricular ejection fraction (women, −2.83; men, −2.12; P=0.011), lower right ventricular muscle mass (women, 1.58; men 2.45; P=0.001), poorer peak oxygen uptake (women, −1.65; men, −1.14; P<0.001), higher VE/VCO2 (ventilation per unit of carbon dioxide production) slopes (women, 0.88; men 0.58; P=0.012), and reduced peak heart rate (women, −2.16; men −1.74; P=0.017). Left ventricular parameters did not differ between sexes. Conclusions—Relative to their respective sex-specific healthy control subjects, derived standard deviation scores in repaired tetralogy of Fallot suggest that women perform poorer than men in terms of right ventricular systolic function as tested by cardiac magnetic resonance and exercise capacity. This effect cannot be explained by selection bias. Further outcome data are required from longitudinal cohort studies. Clinical Trial Registration—URL: http://www.clinicaltrials.gov. Unique identifier: NCT00266188.
影响因子：
120.7
作者：
Canto, John G.;Rogers, William J.;Goldberg, Robert J.;Peterson, Eric D.;Wenger, Nanette K.;Vaccarino, Viola;Kiefe, Catarina I.;Frederick, Paul D.;Sopko, George;Zheng, Zhi-Jie
通讯作者：
Zheng, Zhi-Jie