4.4 Article

Exploring gender differences in trajectories of clinical markers and symptoms after left ventricular assist device implantation

期刊

EUROPEAN JOURNAL OF CARDIOVASCULAR NURSING
卷 20, 期 7, 页码 648-656

出版社

OXFORD UNIV PRESS
DOI: 10.1093/eurjcn/zvab032

关键词

Gender; Biomarker; Symptoms; Ventricular assist device

资金

  1. Office of Research on Women's Health of the National Institutes of Health [K12HD043488]
  2. Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health [K12HD043488]
  3. National Institutes of Health/National Institute of Nursing Research [1R01NR013492]
  4. Innovations Grant through Oregon Health & Science University School of Nursing
  5. National Center for Advancing Translational Sciences of the National Institutes of Health [UL1TR000128]
  6. Achievement Rewards for College Scientists Scholar Award
  7. Oregon Health & Science University School of Nursing Dean's Stipend

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The study found that there were differences in clinical markers between women and men after left ventricular assist device implantation, but their symptoms trajectories were similar.
Aims Despite well-known gender differences in heart failure, it is unknown if clinical markers and symptoms differ between women and men after left ventricular assist device (LVAD) implantation. Our aim was to examine gender differences in trajectories of clinical markers (echocardiographic markers and plasma biomarkers) and symptoms from pre- to post-LVAD implantation. Methods and results This was a secondary analysis of data collected from a study of patients from pre- to 1, 3, and 6 months post-LVAD implantation. Data were collected on left ventricular internal end-diastolic diameter (LVIDd) and ejection fraction (LVEF), plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP), and soluble suppressor of tumorigenicity (sST2). Physical and depressive symptoms were measured using the Heart Failure Somatic Perception Scale and Patient Health Questionnaire-9, respectively. Latent growth curve modelling was used to compare trajectories between women and men. The average age of the sample (n = 98) was 53.3 +/- 13.8 years, and most were male (80.6%) and had non-ischaemic aetiology (65.3%). Pre-implantation, women had significantly narrower LVIDd (P < 0.001) and worse physical symptoms (P = 0.041) compared with men. Between pre- and 6 months post-implantation, women had an increase in plasma sST2 followed by a decrease, whereas men had an overall decrease (slope: P = 0.014; quadratic: P = 0.011). Between 1 and 6 months post-implantation, women had a significantly greater increase in LVEF (P = 0.045) but lesser decline in plasmoa NT-proBNP compared with men (P = 0.025). Conclusion Trajectories of clinical markers differed somewhat between women and men, but trajectories of symptoms were similar, indicating some physiologic but not symptomatic gender differences in response to LVAD.

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