Edvardsson Nils, Garutti Claudio, Rieger Guido, Linker Nicholas J
Division of Cardiology, Sahlgrenska Academy at Sahlgrenska University Hospital, Göteborg, Sweden.
Clin Cardiol. 2014 Oct;37(10):618-25. doi: 10.1002/clc.22300. Epub 2014 May 28.
Syncope is a common clinical problem with a variety of underlying mechanisms, some of which occur more frequently in 1 of the sexes or at a certain age.
There may be clinically significant age- and gender-related differences in patients with unexplained syncope.
Five hundred seventy patients (54% women) with unexplained syncope received an implantable loop recorder (ILR) and were followed until diagnosis or for at least 1 year.
Women were older and more prone to severe trauma during syncope (40.8% vs 29.9%, P = 0.007), and hospitalization was more common at ≥65 years (P = 0.003) without gender difference. Muscle spasms or grand mal seizures were more common in men and at <65 years old. Carotid sinus pressure, exercise testing, coronary angiography and magnetic resonance imaging/computed tomography scans were more commonly performed in men, whereas no test was more common in women. Tilt testing, exercise test, electroencephalography, and neurological or psychiatric evaluation were more common at ≥65 years. There were no age- or gender-related differences in the diagnostic yield of the ILR, whereas patients ≥65 years old more often received specific treatment based on ILR data.
Gender and/or age had relevance for the clinical evaluation, rate of recurrence, and subsequent specific treatment but not for the diagnostic yield of the ILR.
晕厥是一个常见的临床问题，有多种潜在机制，其中一些在某一性别或特定年龄更频繁发生。
不明原因晕厥患者可能存在临床上显著的年龄和性别差异。
570例不明原因晕厥患者（54%为女性）植入可植入式循环记录仪（ILR），并随访至确诊或至少1年。
女性年龄较大，晕厥时更易发生严重创伤（40.8%对29.9%，P = 0.007），≥65岁时住院更常见（P = 0.003），且无性别差异。肌肉痉挛或癫痫大发作在男性和<65岁人群中更常见。男性更常进行颈动脉窦按压、运动试验、冠状动脉造影和磁共振成像/计算机断层扫描，而女性没有哪种检查更常见。倾斜试验、运动试验、脑电图以及神经或精神评估在≥65岁人群中更常见。ILR的诊断率无年龄或性别差异，而≥65岁的患者更常根据ILR数据接受特定治疗。
性别和/或年龄与临床评估、复发率及后续特定治疗有关，但与ILR的诊断率无关。
