Department of Cardiology, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
L'institut du Thorax, Service de Cardiologie, CHU de Nantes, Nantes, France.
Heart Rhythm. 2018 Oct;15(10):1457-1465. doi: 10.1016/j.hrthm.2018.06.019. Epub 2018 Jun 13.
There is limited information on gender differences in patients with Brugada syndrome (BrS) who experienced arrhythmic events (AEs).
The purpose of this study was to compare clinical, electrocardiographic (ECG), electrophysiological, and genetic characteristics between males and females in patients with BrS with their first AE.
The multicenter Survey on Arrhythmic Events in BRUgada Syndrome collected data on the first AE in 678 patients with BrS including 619 males (91.3%) and 59 females (8.7%) aged 0.27-84 years (mean age 42.5 ± 14.1 years) at the time of AE occurrence.
After excluding pediatric patients, it was found that females were older than males (49.5 ± 14.4 years vs 43 ± 12.7 years, respectively; P = .001). Higher proportions of females were observed in the pediatric and elderly populations. In Asians, the male to female ratio for AEs was ≈9-fold higher than that in White. Spontaneous type 1 BrS ECG was associated with an earlier onset of AEs in pediatric females. A similar prevalence (≈65%) of spontaneous type 1 BrS ECG was present in males and females above the age of 60 years. Females less frequently showed spontaneous type 1 BrS ECG (41% vs 69%; P < .001) or arrhythmia inducibility at electrophysiology study (36% vs 66%; P < .001). An SCN5A mutation was more frequently found in females (48% vs 28% in males; P = .007).
This study confirms that female patients with BrS are much rarer, display less type 1 Brugada ECG, and exhibit lower inducibility rates than do males. It shows for the first time that female patients with BrS with AE have higher SCN5A mutation rates as well as the relationship between gender vs age at the onset of AEs and ethnicity.
目前关于发生心律失常事件（AEs）的 Brugada 综合征（BrS）患者的性别差异，相关信息有限。
本研究旨在比较首次发生 AEs 的 BrS 患者中男性和女性的临床、心电图（ECG）、电生理和遗传特征。
心律失常事件在 Brugada 综合征中的多中心调查（Survey on Arrhythmic Events in BRUgada Syndrome）收集了 678 例 BrS 患者的首次 AEs 数据，包括 619 名男性（91.3%）和 59 名女性（8.7%），年龄为 0.27-84 岁（平均年龄 42.5±14.1 岁）。
排除儿科患者后，发现女性比男性年龄大（49.5±14.4 岁比 43±12.7 岁，P=0.001）。儿科和老年人群中女性比例更高。在亚洲人群中，AE 中男女比例是白人的约 9 倍。儿科女性中自发 I 型 BrS ECG 与 AEs 更早发生有关。60 岁以上的男性和女性中，自发 I 型 BrS ECG 的发生率相似（≈65%）。女性较少出现自发 I 型 BrS ECG（41%比 69%，P＜0.001）或电生理检查时心律失常可诱导性（36%比 66%，P＜0.001）。女性更常发现 SCN5A 突变（48%比男性的 28%，P=0.007）。
本研究证实，BrS 女性患者更为罕见，表现为更少的 I 型 Brugada 心电图，电生理检查时的可诱导性更低。这是首次表明 BrS 女性患者的 AE 具有更高的 SCN5A 突变率，以及性别与 AEs 发病年龄和种族之间的关系。
