Sawatari Hiroyuki, Niitani Mayumi
Department of Perioperative and Critical Care Management, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Department of Nursing, Graduate School of Medicine, Ehime University, Shitsukawa, Toon, Ehime, 7910295, Japan.
Heart Vessels. 2025 Mar 6. doi: 10.1007/s00380-025-02527-5.
Previous studies have reported that the clinical features of chronic heart failure (CHF), such as symptoms, prognosis, mental distress, and quality of life (QOL), differ between men and women. However, no studies have shown sex disparities in distress, which has been assessed by multiple indicators in patients with CHF. This study evaluated sex disparities in physical and mental distress among patients with CHF. This prospective multicenter cross-sectional study included outpatients with CHF. Clinical characteristics such as age, sex, and echocardiography findings were extracted from the medical records. Anxiety/depression, selfcare ability, and QOL were assessed using the Hospital Anxiety and Depression Scale (HADS), the European Heart Failure Selfcare Behavior Scale (EHFScBS), and Short Form-12 (SF-12), respectively. The mean age of the participants was 69.7 ± 11.9 years, and 28.3% of the 251 patients were female. The mean left ventricular ejection fraction (LVEF) was 52.0 ± 13.9%, and LVEF was higher in women. The most common underlying disease was ischemic heart disease (38.3%). Multivariate analysis showed that women had significantly higher levels of anxiety/depression, lower mental component summary scores, and reduced physical functioning in terms of QOL, whereas selfcare ability did not differ between women and men. The findings of this study suggest that women have significantly more anxiety/depression and worse physical and mental QOL than men. Thus, more attention should be paid to psychological disorders, including QOL, during CHF management, especially in women.
以往研究报告称,慢性心力衰竭(CHF)的临床特征,如症状、预后、精神困扰和生活质量(QOL),在男性和女性之间存在差异。然而,尚无研究表明在CHF患者中通过多种指标评估的困扰存在性别差异。本研究评估了CHF患者在身体和精神困扰方面的性别差异。这项前瞻性多中心横断面研究纳入了CHF门诊患者。从病历中提取年龄、性别和超声心动图检查结果等临床特征。分别使用医院焦虑抑郁量表(HADS)、欧洲心力衰竭自我护理行为量表(EHFScBS)和简明健康调查问卷12项量表(SF-12)评估焦虑/抑郁、自我护理能力和生活质量。参与者的平均年龄为69.7±11.9岁,251例患者中有28.3%为女性。平均左心室射血分数(LVEF)为52.0±13.9%,女性的LVEF更高。最常见的基础疾病是缺血性心脏病(38.3%)。多变量分析显示,女性的焦虑/抑郁水平显著更高,心理成分综合评分更低,生活质量方面的身体功能也更差,而自我护理能力在女性和男性之间没有差异。本研究结果表明,女性的焦虑/抑郁明显多于男性,身心健康状况也比男性更差。因此,在CHF管理过程中,应更加关注包括生活质量在内的心理障碍,尤其是女性。