Boczar Krzysztof, Dębski Maciej, Ząbek Andrzej, Haberka Kazimierz, Sławuta Agnieszka, Lelakowski Jacek, Małecka Barbara
Department of Electrocardiology, John Paul II Hospital, Cracow, Poland.
Department of Cardiology, County Hospital, Kłodzko, Poland.
Pol Merkur Lekarski. 2017 May 23;42(251):187-192.
Venous stenosis and occlusion (VSO) in the presence of endocardial leads constitute one of the complications of permanent cardiac pacing. At present there are no scientific reports on the influence of sex on the incidence of VSO.
The aim of the study was to examine the influence of sex on the incidence of VSO in patients with earlier implanted endocardial leads in a single-center retrospective analysis.
The material consists of 284 records of consecutive patients admitted to hospital to undergo electrotherapy procedures. In all patients a contrast venography for ipsilateral venous confluence was performed before the procedure. Patients were divided into two groups according to sex criterion. Groups were compared concerning following parameters: demographic characteristics, cardiac implantable electronic device (CIED) characteristics, comorbidities, CHA2DS2-VASc score, selected risk factors for VSO.
Group I consist of 101 females, whereas group II consist of 183 males. Both groups did not differ significantly for age, number of implanted endocardial leads and lead dwell time. In the cohort males were with significantly greater burden of morbidity, reflected by the mean result of CHA2DS2-VASc (P=0.0098). In males there was significantly more often chronic heart failure (P<0.0001), chronic obstructive pulmonary disease (P=0.0450) and tobacco use (P=0.0159). Males had more ICD implanted than females (P=0.0270). In the examine cohort 88 patients (31%) had VSO. There was no statistically significant difference in terms of presence of VSO between females and males (P=0.4685). The detailed analysis of the patients with VSO divided according to sex revealed higher morbidity in males.
The equality of VSO incidence in groups of males and females along with the predominance of factors protecting against VSO in group of males support the assumption that female gender is a protective factor against the development of VSO, equally as known protective factors in males.
心内膜导线存在时的静脉狭窄和闭塞（VSO）是永久性心脏起搏的并发症之一。目前尚无关于性别对VSO发生率影响的科学报道。
本研究的目的是通过单中心回顾性分析，探讨性别对早期植入心内膜导线患者VSO发生率的影响。
材料包括284例连续入院接受电疗程序的患者记录。所有患者在手术前均进行了同侧静脉汇合造影。根据性别标准将患者分为两组。比较两组的以下参数：人口统计学特征、心脏植入式电子设备（CIED）特征、合并症、CHA2DS2-VASc评分、VSO的选定危险因素。
第一组包括101名女性，而第二组包括183名男性。两组在年龄、植入的心内膜导线数量和导线留置时间方面无显著差异。在队列中，男性的发病负担明显更大，这通过CHA2DS2-VASc的平均结果反映出来（P=0.0098）。男性中慢性心力衰竭（P<0.0001）、慢性阻塞性肺疾病（P=0.0450）和吸烟（P=0.0159）的发生率明显更高。男性植入ICD的人数多于女性（P=0.0270）。在研究队列中，88例患者（31%）发生了VSO。女性和男性在VSO存在方面无统计学显著差异（P=0.4685）。按性别划分的VSO患者的详细分析显示男性的发病率更高。
男性和女性组中VSO发生率的平等以及男性组中预防VSO的因素占主导地位，支持了女性性别是预防VSO发生的保护因素这一假设，这与男性中已知的保护因素相同。
