PMID- 16730570
OWN - NLM
STAT- MEDLINE
DCOM- 20060711
LR  - 20071115
IS  - 1557-3117 (Electronic)
IS  - 1053-2498 (Linking)
VI  - 25
IP  - 6
DP  - 2006 Jun
TI  - Prognostic stratification of women with chronic heart failure referred for heart 
      transplantation: relevance of gender as compared with gender-related 
      characteristics.
PG  - 648-52
AB  - BACKGROUND: Few studies are available regarding prognostic stratification of 
      women with severe chronic heart failure (CHF). Although women seem to have a 
      better outcome than men, this may be due to favorable baseline characteristics. 
      METHODS: We analyzed a cohort of CHF patients referred for heart transplantation 
      (HT) who underwent clinical/laboratory/instrumental evaluation. Women and men 
      were frequency matched for baseline age (53 +/- 14 vs 53 +/- 9 years, p = 0.92), 
      left ventricular ejection fraction (33 +/- 10 vs 31 +/- 8%, p = 0.90) and 
      ischemic etiology (17 vs 22%, p = 0.50). RESULTS: A total of 198 patients were 
      analyzed (109 women matched to 89 men). In addition to matching parameters, 
      prevalence of severe symptoms, diabetes and hypertension were also comparable (p 
      > or = 0.25). After 3 years, cardiovascular death or need for HT (CD/HT) 
      event-free survival was 78 +/- 4% in women and 50 +/- 6% in men (p = 0.005). On 
      multivariate analysis, female gender was associated with a lower risk of CD/HT 
      (relative risk [RR] 0.52; 95% confidence interval [CI] 0.30 to 0.89; p = 0.017), 
      independently of symptoms, blood pressure (BP), left ventricular end-diastolic 
      diameter (LVEDD) and mitral regurgitation (MR). Nevertheless, CD/HT event-free 
      survival at 3 years was 49 +/- 9% for women with New York Heart Association 
      (NYHA) Class III or IV status, who presented with either severe MR, mean BP < or 
      =60 mm Hg or LVEDD > or =35 mm/m2. CONCLUSIONS: In advanced CHF, women patients 
      seem to have a better prognosis irrespective of baseline characteristics, 
      supporting the hypothesis that female gender is protective against myocardial 
      injury. However, women with severe symptoms accompanied by either hypotension, 
      severe left ventricular enlargement or MR are at high risk and deserve cautious 
      follow-up and consideration for HT.
FAU - Grigioni, Francesco
AU  - Grigioni F
AD  - Cardiology Institute, University of Bologna, Bologna, Italy. 
      francesco.grigioni@unibo.it
FAU - Barbieri, Andrea
AU  - Barbieri A
FAU - Russo, Antonio
AU  - Russo A
FAU - Reggianini, Letizia
AU  - Reggianini L
FAU - Bonatti, Silvia
AU  - Bonatti S
FAU - Potena, Luciano
AU  - Potena L
FAU - Fabbri, Francesca
AU  - Fabbri F
FAU - Coccolo, Fabio
AU  - Coccolo F
FAU - Magnani, Gaia
AU  - Magnani G
FAU - Bursi, Francesca
AU  - Bursi F
FAU - Magelli, Carlo
AU  - Magelli C
FAU - Modena, Maria G
AU  - Modena MG
FAU - Branzi, Angelo
AU  - Branzi A
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20060502
PL  - United States
TA  - J Heart Lung Transplant
JT  - The Journal of heart and lung transplantation : the official publication of the 
      International Society for Heart Transplantation
JID - 9102703
SB  - IM
MH  - Adult
MH  - Aged
MH  - Female
MH  - Heart Failure/drug therapy/*mortality/*surgery
MH  - Heart Transplantation
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Prognosis
MH  - Sex Factors
MH  - Survival Analysis
MH  - Treatment Outcome
EDAT- 2006/05/30 09:00
MHDA- 2006/07/13 09:00
CRDT- 2006/05/30 09:00
PHST- 2005/08/04 00:00 [received]
PHST- 2005/10/10 00:00 [revised]
PHST- 2006/02/11 00:00 [accepted]
PHST- 2006/05/30 09:00 [pubmed]
PHST- 2006/07/13 09:00 [medline]
PHST- 2006/05/30 09:00 [entrez]
AID - S1053-2498(06)00157-4 [pii]
AID - 10.1016/j.healun.2006.02.004 [doi]
PST - ppublish
SO  - J Heart Lung Transplant. 2006 Jun;25(6):648-52. doi: 
      10.1016/j.healun.2006.02.004. Epub 2006 May 2.