Kurzyna Paweł, Witowicz Anna, Kędzierski Piotr, Florczyk Michał, Banaszkiewicz Marta, Szwed Piotr, Piłka Michał, Gąsecka Aleksandra, Pietrasik Arkadiusz, Torbicki Adam, Kurzyna Marcin, Darocha Szymon
Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, European Health Center Otwock, Centre of Postgraduate Medical Education, ERN-LUNG Member, 05-400 Otwock, Poland.
Doctoral School of Translational Medicine, Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland.
J Clin Med. 2025 Jan 29;14(3):899. doi: 10.3390/jcm14030899.
Several studies describe the sex-specific differences in cardiovascular diseases. However, there is still limited research reporting the difference between men and women with chronic thromboembolic pulmonary hypertension (CTEPH) treated with balloon pulmonary angioplasty (BPA). The aim of this study was to evaluate sex-specific differences in patients with CTEPH treated with BPA. This retrospective study included CTEPH patients treated with BPA. The patients' hemodynamic and clinical parameters were assessed at baseline and 3 months after completion of BPA treatment. This study included 94 patients (44 women, 46.8%). At baseline, women had higher systolic pulmonary arterial pressure (sPAP) (76 ± 18.5 vs. 85 ± 17.6 mmHg; = 0.03) and pulmonary vascular resistance (8.21 [5.55-10.17] vs. 9.89 [6.31-14.06] Wood Units; = 0.03) compared to men. There were no differences in clinical characteristics between the sexes. At follow-up, women had lower sPAP (49 [41-54] vs. 43 [37-49] mmHg; = 0.04) and pulmonary capillary wedge pressure (10 [9-14] vs. 9 [8-11] mmHg; = 0.03), but a higher cardiac index (2.57 ± 0.53 vs. 2.82 ± 0.50 L/min/m; = 0.03), as well as better Dyspnea Borg Scale outcomes, compared to men. Women had a greater reduction in mean pulmonary artery pressure (-43% vs. -37%; = 0.049) than men. At baseline, women with CTEPH had worse hemodynamic parameters than men despite similar clinical symptoms. However, the hemodynamic status of women was better after BPA therapy. Hence, women seem better adapted to the disease at baseline and respond better to BPA. Further data are needed to investigate whether the management of CTEPH patients should be sex-differentiated.
多项研究描述了心血管疾病中的性别差异。然而，关于接受球囊肺动脉成形术（BPA）治疗的慢性血栓栓塞性肺动脉高压（CTEPH）男性和女性之间差异的研究报道仍然有限。本研究的目的是评估接受BPA治疗的CTEPH患者的性别差异。这项回顾性研究纳入了接受BPA治疗的CTEPH患者。在基线和BPA治疗完成后3个月评估患者的血流动力学和临床参数。本研究包括94例患者（44例女性，占46.8%）。在基线时，与男性相比，女性的收缩期肺动脉压（sPAP）更高（76±18.5 vs. 85±17.6 mmHg；P = 0.03），肺血管阻力更高（8.21[5.55 - 10.17] vs. 9.89[6.31 - 14.06]伍德单位；P = 0.03）。两性之间的临床特征没有差异。在随访时，与男性相比，女性的sPAP更低（49[41 - 54] vs. 43[37 - 49] mmHg；P = 0.04），肺毛细血管楔压更低（10[9 - 14] vs. 9[8 - 11] mmHg；P = 0.03），但心脏指数更高（2.57±0.53 vs. 2.82±0.50 L/min/m²；P = 0.03），以及呼吸困难Borg量表结果更好。女性的平均肺动脉压降低幅度比男性更大（-43% vs. -37%；P = 0.049）。在基线时，CTEPH女性尽管临床症状相似，但血流动力学参数比男性更差。然而，BPA治疗后女性的血流动力学状况更好。因此，女性在基线时似乎对疾病的适应性更好，对BPA的反应也更好。需要进一步的数据来研究CTEPH患者的管理是否应进行性别区分。
