Gender Differences in Patients with Takotsubo Cardiomyopathy: Multi-Center Registry from Tokyo CCU Network.
Gender Differences in Patients with Takotsubo Cardiomyopathy: Multi-Center Registry from Tokyo CCU Network.
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DOI：
10.1371/journal.pone.0136655
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Takayama M
中科院分区：
文献类型：
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作者：
Murakami T;Yoshikawa T;Maekawa Y;Ueda T;Isogai T;Sakata K;Nagao K;Yamamoto T;Takayama M
takotsubo心肌病（TC）的临床特征性别差异仍有待确定。本研究的目的是评估男性和女性TC患者临床特征的差异。我们从2010年1月1日至2012年12月31日收集的东京CCU网络数据库中获得368例诊断为TC的患者的临床信息（男性84例，女性284例）；该网络由东京（日本）大都市区的71个心血管中心组成。我们试图描述住院期间的临床差异，比较男性和女性TC患者。男女患者在心尖球囊类型、超声心动图中位射血分数、严重室性心律失常（如室性心动过速或纤颤）或心血管死亡方面无显著差异。男性患者比女性患者年轻（男性患者住院时的中位年龄为72岁，女性患者为76岁；p = 0.040）。男性患者既往身体应激高于女性患者（50.0% vs.31.3%, p = 0.002），女性患者既往情绪应激高于女性患者（19.0% vs. 31.0%, p = 0.039）。重度泵衰竭（定义为Killip Class > III）（20.2%比10.6%,p = 0.020）和心肺支持治疗（28.6%比12.7%,p < 0.001）在男性患者中比女性患者更常见。多因素分析显示，男性（优势比= 4.32,95% CI = 1.41-13.6, p = 0.011）是心血管死亡、严重泵衰竭和严重室性心律失常等不良心脏事件的独立预测因子。在我们的数据集中，男性患者在住院期间的心脏并发症似乎比女性患者更常见。需要进一步调查以澄清造成所观察到的性别差异的潜在机制。
The clinical features of gender differences in takotsubo cardiomyopathy (TC) remain to be determined. The aim of this study was to evaluate the differences in clinical characteristics of male and female patients with TC. We obtained the clinical information of 368 patients diagnosed with TC (84 male, 284 female) from the Tokyo CCU Network database collected from 1 January 2010 to 31 December 2012; the Network is comprised of 71 cardiovascular centers in the Tokyo (Japan) metropolitan area. We attempted to characterize clinical differences during hospitalization, comparing male and female patients with TC. There were no significant differences in apical ballooning type, median echocardiography ejection fraction, serious ventricular arrhythmias (such as ventricular tachycardia or fibrillation), or cardiovascular death between male and female patients. Male patients were younger than female patients (median age at hospitalization for male patients was 72 years vs. 76 years for female patients; p = 0.040). Prior physical stress was more common in male than female patients (50.0% vs.31.3%; p = 0.002), while emotional stress was more common in female patients (19.0% vs. 31.0%; p = 0.039). Severe pump failure (defined as Killip Class > III) (20.2% vs. 10.6%; p = 0.020) and cardiopulmonary supportive therapies (28.6% vs. 12.7%, p < 0.001) were more common in male than female patients. Multivariate analysis revealed that male gender (odds ratio = 4.32, 95% CI = 1.41–13.6, p = 0.011) was an independent predictor of adverse composite cardiac events, including cardiovascular death, severe pump failure, and serious ventricular arrhythmia. Cardiac complications in our dataset appeared to be more common in male than female patients with TC during their hospitalization. Further investigation is required to clarify the underlying mechanisms responsible for the observed gender differences.