Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Leiden, The Netherlands.
ESC Heart Fail. 2021 Oct;8(5):3539-3546. doi: 10.1002/ehf2.13503. Epub 2021 Aug 6.
Secondary mitral regurgitation (MR) is more frequent in men than in women. However, little is known about differences in prognosis between men and women with secondary MR. The objective of this study is to investigate the sex distribution of secondary MR and the prognostic differences between sexes.
Patients with significant secondary MR, of both ischaemic and non-ischaemic aetiologies, were identified through the departmental electronic patient files and retrospectively analysed. The primary endpoint was all-cause mortality.
A total of 698 patients (mean age 66 ± 11 years) with significant secondary MR were included: 471 (67%) men and 227 (33%) women. Ischaemic heart failure was significantly more common in men (61%), whereas non-ischaemic heart failure was more prevalent in women (63%). Women had significantly smaller left ventricular (LV) volumes when compared with men and more preserved LV systolic function when assessed with LV global longitudinal strain (GLS; 8.5 ± 4.1% vs. 7.5 ± 3.6%; P = 0.004). Women more often underwent surgical mitral valve repair (34%) when compared with men (26%), although no differences were observed for transcatheter mitral valve repair. During a median follow-up of 57 [interquartile range 29-110] months, 373 (53%) patients died. Women showed significantly lower mortality rates at 1-, 2- and 5-year follow-up (9%, 16% and 33% vs. 10%, 20% and 42%) when compared with men (P = 0.001).
Significant secondary MR is more frequently observed in men as compared with women and is associated with worse prognosis.
继发性二尖瓣反流（MR）在男性中比在女性中更为常见。然而，对于继发性 MR 患者的性别与预后之间的差异知之甚少。本研究旨在探讨继发性 MR 的性别分布以及性别之间的预后差异。
通过部门电子病历系统识别出有明显继发性 MR 的患者（包括缺血性和非缺血性病因），并进行回顾性分析。主要终点是全因死亡率。
共纳入 698 例有明显继发性 MR 的患者（平均年龄 66±11 岁）：471 例（67%）为男性，227 例（33%）为女性。男性中缺血性心力衰竭更为常见（61%），而女性中非缺血性心力衰竭更为常见（63%）。与男性相比，女性的左心室（LV）容积明显较小，且左室整体纵向应变（GLS）评估的 LV 收缩功能保存更好（8.5±4.1%比 7.5±3.6%；P=0.004）。与男性相比（26%），女性更多地接受了二尖瓣修复手术（34%），尽管经导管二尖瓣修复术则无差异。在中位随访 57 [29-110]个月期间，373 例（53%）患者死亡。与男性相比（9%、16%和 33%），女性在 1、2 和 5 年随访时的死亡率明显较低（10%、20%和 42%）（P=0.001）。
与女性相比，男性中更常观察到明显的继发性 MR，并且与更差的预后相关。
