心肾综合征的性别差异:CARDIOREN 登记的启示。

IF 3.8 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Current Heart Failure Reports Pub Date : 2023-06-01 Epub Date: 2023-05-24 DOI:10.1007/s11897-023-00598-x
Marta Cobo Marcos, Rafael de la Espriella, Jara Gayán Ordás, Isabel Zegrí, Antonia Pomares, Pau Llácer, Aleix Fort, Adriana Rodríguez Chavarri, Ana Méndez, Zorba Blázquez, Pedro Caravaca Pérez, Jorge Rubio Gracia, Alejandro Recio-Mayoral, Jose Manuel García Pinilla, Maria Jose Soler, Ramón Garrido González, Jose Luis Górriz, Miguel González Rico, Almudena Castro, Julio Núñez
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引用次数: 0

摘要

工作目的虽然已对心力衰竭(HF)或肾脏疾病(KD)的性别差异进行了单独分析,但尚未描述不同性别的主要心肾表型。本研究旨在探讨当代心力衰竭门诊患者队列中与性别相关的心肾综合征(CRS)差异:对西班牙心肾登记处(CARDIOREN)进行了分析。CARDIOREN 登记是一项前瞻性多中心观察登记,包括来自西班牙 13 家高血压诊所的 1107 名慢性门诊高血压患者(37% 为女性)。估计肾小球滤过率(eGFR)为 2 的患者占所有高血压患者的 59.1%,女性患者的比例更高(63.2% 对 56.6%,p = 0.032,中位年龄:81 岁,IQR:74-86)。在肾功能不全患者中,女性出现射血分数保留型心房颤动(HFpEF)的几率更高(几率比 [OR] = 4.07;置信区间 [CI] 95%:2.65-6.25, p
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Sex differences in Cardiorenal Syndrome: Insights from CARDIOREN Registry.

Purpose of the work: Although sex-specific differences in heart failure (HF) or kidney disease (KD) have been analyzed separately, the predominant cardiorenal phenotype by sex has not been described. This study aims to explore the sex-related differences in cardiorenal syndrome (CRS) in a contemporary cohort of outpatients with HF.

Findings: An analysis of the Cardiorenal Spanish registry (CARDIOREN) was performed. CARDIOREN Registry is a prospective multicenter observational registry including 1107 chronic ambulatory HF patients (37% females) from 13 Spanish HF clinics. Estimated Glomerular Filtration Rate (eGFR) < 60 ml/min/1.73 m2 was present in 59.1% of the overall HF population, being this prevalence higher in the female population (63.2% vs. 56.6%, p = 0.032, median age: 81 years old, IQR:74-86). Among those with kidney dysfunction, women displayed higher odds of showing HF with preserved ejection fraction (HFpEF) (odds ratio [OR] = 4.07; confidence interval [CI] 95%: 2.65-6.25, p < 0.001), prior valvular heart disease (OR = 1.76; CI 95%:1.13-2.75, p = 0.014), anemia (OR: 2.02; CI 95%:1.30-3.14, p = 0.002), more advanced kidney disease (OR for CKD stage 3: 1.81; CI 95%:1.04-3.13, p = 0.034; OR for CKD stage 4: 2.49, CI 95%:1.31-4.70, p = 0.004) and clinical features of congestion (OR:1.51; CI 95%: 1.02-2.25, p = 0.039). On the contrary, males with cardiorenal disease showed higher odds of presenting HF with reduced ejection fraction (HFrEF) (OR:3.13; CI 95%: 1.90-5.16, p < 0.005), ischemic cardiomyopathy (OR:2.17; CI 95%: 1.31-3.61, p = 0.003), hypertension (OR = 2.11; CI 95%:1.18-3.78, p = 0.009), atrial fibrillation (OR:1.71; CI 95%: 1.06-2.75, p = 0.025), and hyperkalemia (OR:2.43, CI 95%: 1.31-4.50, p = 0.005). In this contemporary registry of chronic ambulatory HF patients, we observed sex-related differences in patients with combined heart and kidney disease. The emerging cardiorenal phenotype characterized by advanced CKD, congestion, and HFpEF was predominantly observed in women, whereas HFrEF, ischemic etiology, hypertension, hyperkalemia, and atrial fibrillation were more frequently observed in men.

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来源期刊
Current Heart Failure Reports
Current Heart Failure Reports Medicine-Emergency Medicine
CiteScore
5.30
自引率
0.00%
发文量
44
期刊介绍: This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of heart failure. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as investigative, pharmacologic, and nonpharmacologic therapies, pathophysiology, and prevention. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.
期刊最新文献
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