Sex Differences in Clinical Characteristics and 2-Year Prognosis of Patients with Heart Failure Grouped by Left Ventricular Ejection Fraction Status
Sex Differences in Clinical Characteristics and 2-Year Prognosis of Patients with Heart Failure Grouped by Left Ventricular Ejection Fraction Status
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DOI：
10.1536/ihj.20-321
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发表时间：
2020-11-01
影响因子：
1.5
通讯作者：
Tian, Jianli
中科院分区：
文献类型：
--
作者：
Wang, Conglin;Zhou, Yan;Tian, Jianli
在新的左心室射血分数(LVEF)分级标准提出后，许多研究集中在心力衰竭(HF)伴EF降低(HFrEF)、HF伴中段EF(HFmrEF)和HF伴EF保留(HFpEF)之间的差异。然而，在新的标准中，缺乏关于性别相关预后差异的共识。本研究旨在探讨按新标准定义的中国心力衰竭住院患者的临床特征和预后的性别差异。从2014年3月至2016年2月，2284名有症状的心衰患者被连续纳入这项前瞻性研究。使用病例资料和两年的随访观察来确定临床特征和预后的性别差异。当比较男性和女性的HFrEF、HFmrEF和HFpEF时，女性年龄较大，更有可能因首次诊断为心衰而住院，并且平均左心室射血分数较低。在心力衰竭后3个月、12个月和24个月，女性的全因死亡率高于男性。经多因素调整后，男性与女性24个月全因死亡的危险性比(HR)分别为1.113(0.728，1.704)，P=0.620；1.063(0.730，1.548)，P=0.750；0.619(0.240，1.593)，P=0.320。在HFrEF、HFmrEF和HFpEF中，症状性心衰患者的临床特征存在性别差异，但在住院后2年内，女性和男性的结果相似。
After the new left ventricular ejection fraction (LVEF) classification criteria emerged, many studies have focused on the differences between heart failure (HF) with reduced EF (HFrEF), HF with midrange EF (HFmrEF), and HF with preserved EF (HFpEF). However, the lack of consensus on sex-related differences in prognosis within the new standard remains. We aimed to explore sex differences in the clinical characteristics and prognoses of Chinese inpatients with HF defined according to the new standard. From March 2014 to February 2016, 2284 patients with symptomatic HF were consecutively recruited to this prospective research. Case data and 2-year follow-up observations were used to identify sex differences in clinical characteristics and prognoses. When comparing men and women with HFrEF, HFmrEF, and HFpEF, women were older, were more likely to be hospitalized for the first diagnosis of HF, and had lower mean LVEF. Women had a higher tendency of all-cause mortality than did men at 3, 12, and 24 months following HF. After multivariate adjustment, the hazard ratios (HRs) for 24-month all-cause mortality for HFrEF, HFmrEF, and HFpEF were 1.113 (0.728, 1.704), P = 0.620; 1.063 (0.730, 1.548), P = 0.750; and 0.619 (0.240, 1.593), P = 0.320, for men versus women, respectively. There were some sex differences in the clinical characteristics of patients with symptomatic HF in HFrEF, HFmrEF, and HFpEF, but women and men had comparable outcomes over the 2-year period following hospitalization.