Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, PO Box 4950 Nydalen, 0424 Oslo, Norway.
ProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
Europace. 2021 Jul 18;23(7):1084-1091. doi: 10.1093/europace/euab077.
We aimed to assess sex-specific phenotypes and disease progression, and their relation to exercise, in arrhythmogenic cardiomyopathy (AC) patients.
In this longitudinal cohort study, we included consecutive patients with AC from a referral centre. We performed echocardiography at baseline and repeatedly during follow-up. Patients' exercise dose at inclusion was expressed as metabolic equivalents of task (MET)-h/week. Ventricular arrhythmia (VA) was defined as aborted cardiac arrest, sustained ventricular tachycardia, or appropriate therapy by implantable cardioverter-defibrillator. We included 190 AC patients (45% female, 51% probands, age 41 ± 17 years). Ventricular arrhythmia had occurred at inclusion or occurred during follow-up in 85 patients (33% of females vs. 55% of males, P = 0.002). Exercise doses were higher in males compared with females [25 (interquartile range, IQR 14-51) vs. 12 (IQR 7-22) MET-h/week, P < 0.001]. Male sex was a marker of proband status [odds ratio (OR) 2.6, 95% confidence interval (CI) 1.4-5.0, P = 0.003] and a marker of VA (OR 2.6, 95% CI 1.4-5.0, P = 0.003), but not when adjusted for exercise dose and age (adjusted OR 1.8, 95% CI 0.9-3.6, P = 0.12 and 1.5, 95% CI 0.7-3.1, P = 0.30, by 5 MET-h/week increments). In all, 167 (88%) patients had ≥2 echocardiographic examinations during 6.9 (IQR 4.7-9.8) years of follow-up. We observed no sex differences in deterioration of right or left ventricular dimensions and functions.
Male AC patients were more often probands and had higher prevalence of VA than female patients, but not when adjusting for exercise dose. Importantly, disease progression was similar between male and female patients.
我们旨在评估致心律失常性心肌病（AC）患者的性别特异性表型和疾病进展及其与运动的关系。
在这项纵向队列研究中，我们纳入了来自一个转诊中心的连续 AC 患者。我们在基线和随访期间重复进行超声心动图检查。患者在纳入时的运动剂量表示为代谢当量任务（MET）-h/周。室性心律失常（VA）定义为心脏骤停、持续性室性心动过速或植入式心脏复律除颤器的适当治疗。我们纳入了 190 名 AC 患者（45%为女性，51%为先证者，年龄 41±17 岁）。85 名患者（33%的女性与 55%的男性，P=0.002）在纳入时或随访期间发生了 VA。男性的运动剂量高于女性[25（四分位距，IQR 14-51）比 12（IQR 7-22）MET-h/周，P<0.001]。男性是先证者状态的标志[优势比（OR）2.6，95%置信区间（CI）1.4-5.0，P=0.003]和 VA 的标志（OR 2.6，95%CI 1.4-5.0，P=0.003），但在调整运动剂量和年龄后并非如此（调整后的 OR 1.8，95%CI 0.9-3.6，P=0.12 和 1.5，95%CI 0.7-3.1，P=0.30，每增加 5 MET-h/周）。总共 167 名（88%）患者在 6.9（IQR 4.7-9.8）年的随访期间进行了≥2 次超声心动图检查。我们观察到在右心室或左心室的大小和功能恶化方面，男性和女性之间没有性别差异。
与女性患者相比，男性 AC 患者更常为先证者，且 VA 的患病率更高，但在调整运动剂量后并非如此。重要的是，男性和女性患者的疾病进展相似。
