Angeli Francesco, Bergamaschi Luca, Rinaldi Andrea, Paolisso Pasquale, Armillotta Matteo, Stefanizzi Andrea, Sansonetti Angelo, Amicone Sara, Impellizzeri Andrea, Bodega Francesca, Canton Lisa, Suma Nicole, Fedele Damiano, Bertolini Davide, Tattilo Francesco Pio, Cavallo Daniele, Di Iuorio Ornella, Ryabenko Khrystyna, Casuso Alvarez Marcello, Galiè Nazzareno, Foà Alberto, Pizzi Carmine
Cardiology Unit, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy.
Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, University of Bologna, 40138 Bologna, Italy.
J Clin Med. 2023 Apr 19;12(8):2958. doi: 10.3390/jcm12082958.
Cardiac masses (CM) represent a heterogeneous clinical scenario, and sex-related differences of these patients remain to be established.
To evaluate sex-related disparities in CMs regarding clinical presentation and outcomes.
The study cohort included 321 consecutive patients with CM enrolled in our Centre between 2004 and 2022. A definitive diagnosis was achieved by histological examination or, in the case of cardiac thrombi, with radiological evidence of thrombus resolution after anticoagulant treatment. All-cause mortality at follow-up was evaluated. Multivariable regression analysis assessed the potential prognostic disparities between men and women.
Out of 321 patients with CM, 172 (54%) were female. Women were more frequently younger ( = 0.02) than men. Regarding CM histotypes, females were affected by benign masses more frequently (with cardiac myxoma above all), while metastatic tumours were more common in men ( < 0.001). At presentation, peripheral embolism occurred predominantly in women ( = 0.03). Echocardiographic features such as greater dimension, irregular margin, infiltration, sessile mass and immobility were far more common in men. Despite a better overall survival in women, no sex-related differences were observed in the prognosis of benign or malignant masses. In fact, in multivariate analyses, sex was not independently associated with all-cause death. Conversely, age, smoking habit, malignant tumours and peripheral embolism were independent predictors of mortality.
In a large cohort of cardiac masses, a significant sex-related difference in histotype prevalence was found: Benign CMs affected female patients more frequently, while malignant tumours affected predominantly men. Despite better overall survival in women, sex did not influence prognosis in benign and malignant masses.
心脏肿物（CM）代表了一种异质性的临床情况，这些患者的性别差异仍有待确定。
评估心脏肿物在临床表现和预后方面的性别差异。
研究队列包括2004年至2022年期间在我们中心连续纳入的321例CM患者。通过组织学检查确诊，或者对于心脏血栓，通过抗凝治疗后血栓溶解的放射学证据确诊。评估随访期间的全因死亡率。多变量回归分析评估了男性和女性之间潜在的预后差异。
在321例CM患者中，172例（54%）为女性。女性比男性更年轻（P = 0.02）。关于CM组织类型，女性更常受良性肿物影响（尤其是心脏黏液瘤），而转移性肿瘤在男性中更常见（P < 0.001）。就诊时，外周栓塞主要发生在女性中（P = 0.03）。超声心动图特征如更大尺寸、不规则边缘、浸润、无蒂肿物和固定不动在男性中更为常见。尽管女性总体生存率更高，但在良性或恶性肿物的预后方面未观察到性别差异。事实上，在多变量分析中，性别与全因死亡无独立相关性。相反，年龄、吸烟习惯、恶性肿瘤和外周栓塞是死亡的独立预测因素。
在一大群心脏肿物患者中，发现组织类型患病率存在显著的性别差异：良性CM更频繁地影响女性患者，而恶性肿瘤主要影响男性。尽管女性总体生存率更好，但性别并未影响良性和恶性肿物的预后。
