Gender differences in patients with Brugada syndrome and arrhythmic events: Data from a survey on arrhythmic events in 678 patients
Por:
Milman A, Gourraud JB, Andorin A, Postema PG, Sacher F, Mabo P, Conte G, Giustetto C, Sarquella-Brugada G, Hochstadt A, Kim SH, Juang JJ, Maeda S, Takahashi Y, Kamakura T, Aiba T, Leshem E, Michowitz Y, Rahkovich M, Mizusawa Y, Arbelo E, Huang Z, Denjoy I, Wijeyeratne YD, Napolitano C, Brugada R, Casado-Arroyo R, Champagne J, Calo L, Tfelt-Hansen J, Priori SG, Takagi M, Veltmann C, Delise P, Corrado D, Behr ER, Gaita F, Yan GX, Brugada-Terradellas J, Leenhardt A, Wilde AAM, Brugada P, Kusano KF, Hirao K, Nam GB, Probst V and Belhassen B
Publicada:
1 oct 2018
Ahead of Print:
13 jun 2018
Resumen:
BACKGROUND There is limited information on gender differences in patients with Brugada syndrome (BrS) who experienced arrhythmic events (AEs).
OBJECTIVE The purpose of this study was to compare clinical, electrocardiographic (ECG), electrophysiological, and genetic characteristics between males and females in patients with BrS with their first AE.
METHODS The multicenter Survey on Arrhythmic Events in BRUgada Syndrome collected data on the first AE in 678 patients with BrS including 619 males (91.3%) and 59 females (8.7%) aged 0.27-84 years (mean age 42.5 +/- 14.1 years) at the time of AE occurrence.
RESULTS After excluding pediatric patients, it was found that females were older than males (49.5 +/- 14.4 years vs 43 +/- 12.7 years, respectively; P = .001). Higher proportions of females were observed in the pediatric and elderly populations. In Asians, the male to female ratio for AEs was approximate to 9-fold higher than that in White. Spontaneous type 1 BrS ECG was associated with an earlier onset of AEs in pediatric females. A similar prevalence (approximate to 65%) of spontaneous type 1 BrS ECG was present in males and females above the age of 60 years. Females less frequently showed spontaneous type 1 BrS ECG (41% vs 69%; P < .001) or arrhythmia inducibility at electrophysiology study (36% vs 66%; P < .001). An SCN5A mutation was more frequently found in females (48% vs 28% in males; P = .007).
CONCLUSION This study confirms that female patients with BrS are much rarer, display less type 1 Brugada ECG, and exhibit lower inducibility rates than domales. It shows for the first time that female patients with BrS with AE have higher SCN5A mutation rates as well as the relationship between gender vs age at the onset of AEs and ethnicity. (C) 2018 Heart Rhythm Society. All rights reserved.
Filiaciones:
Milman A:
Department of Cardiology, Tel Aviv Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Gourraud JB:
L'institut du Thorax, Service de Cardiologie, CHU de Nantes, Nantes, France
Andorin A:
L'institut du Thorax, Service de Cardiologie, CHU de Nantes, Nantes, France
Postema PG:
Heart Centre AMC, Department of Clinical and Experimental Cardiology, AMC, University of Amsterdam, Amsterdam Netherlands
Sacher F:
Hôpital Cardiologique du Haut-Lévêque Université Bordeaux, LIRYC Institute, Bordeaux, France
Mabo P:
Cardiology and Vascular Disease Division, Rennes University Health Centre, Rennes, France
Conte G:
Heart Rhythm Management Centre, UZ-VUB, Brussels, Belgium
Giustetto C:
Division of Cardiology, University of Torino, Department of Medical Sciences, Città della Salute e della Scienza Hospital, Torino, Italy
Sarquella-Brugada G:
Pediatric Arrhythmias, Electrophysiology and Sudden Death Unit Cardiology, Department Hospital Sant Joan de Déu, Barcelona - Universitat de Barcelona, Spain
Hochstadt A:
Department of Internal Medicine J, Tel-Aviv Medical Center, Tel Aviv, Israel
Kim SH:
Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
Juang JJ:
Cardiovascular Center and Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
Maeda S:
Heart Rhythm Center, Tokyo Medical and Dental University, Tokyo, Japan
Takahashi Y:
Heart Rhythm Center, Tokyo Medical and Dental University, Tokyo, Japan
Kamakura T:
Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
Aiba T:
Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
Leshem E:
Department of Cardiology, Tel Aviv Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
Michowitz Y:
Department of Cardiology, Tel Aviv Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Rahkovich M:
Department of Cardiology, Tel Aviv Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Arrhythmia Services, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
Mizusawa Y:
Heart Centre AMC, Department of Clinical and Experimental Cardiology, AMC, University of Amsterdam, Amsterdam Netherlands
Arbelo E:
Cardiology Department, Cardiovascular Institute, Hospital Clinic and IDIBAPS, Barcelona, Catalonia, Spain
Huang Z:
Department of Cardiology, the First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China
Denjoy I:
Service de Cardiologie et CNMR Maladies Cardiaques Héréditaires Rares, Hôpital Bichat, Paris, and Université Paris Diderot, Sorbonne, Paris, France
Wijeyeratne YD:
Cardiovascular Sciences, St. George's University of London and Cardiology Clinical Academic Group St. George's University Hospitals NHS Foundation Trust, London, UK
Napolitano C:
Molecular Cardiology, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
Brugada R:
Cardiovascular Genetics Center, University of Girona-IDIBGI, Girona, Spain
Medical Science Department, School of Medicine, University of Girona, Girona, Spain
Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
Casado-Arroyo R:
Department of Cardiology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium
Champagne J:
Quebec Heart and Lung Institute, Quebec City, Canada
Calo L:
Division of Cardiology, Policlinico Casilino, Roma, Italy
Tfelt-Hansen J:
Department of Forensic Medicine, Faculty of Medical Sciences, University of Copenhagen, Denmark
Priori SG:
Molecular Cardiology, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
Takagi M:
Division of Cardiac Arrhythmia, Kansai Medical University Medical Center, Moriguchi, Japan
Veltmann C:
Rhythmology and Electrophysiology, Department of Cardiology, Hannover Medical School, Hannover, Germany
Delise P:
Division of Cardiology, Hospital of Peschiera del Garda, Veneto, Italy
Corrado D:
Department of Cardiac, Thoracic and Vascular Sciences University of Padova, Padova, Italy
Behr ER:
Cardiovascular Sciences, St. George's University of London and Cardiology Clinical Academic Group St. George's University Hospitals NHS Foundation Trust, London, UK
Gaita F:
Division of Cardiology, University of Torino, Department of Medical Sciences, Città della Salute e della Scienza Hospital, Torino, Italy
Yan GX:
Lankenau Medical Center, Wynnewood, Pennsylvania, USA
Brugada-Terradellas J:
Cardiology Department, Cardiovascular Institute, Hospital Clinic and IDIBAPS, Barcelona, Catalonia, Spain
Leenhardt A:
Service de Cardiologie et CNMR Maladies Cardiaques Héréditaires Rares, Hôpital Bichat, Paris, and Université Paris Diderot, Sorbonne, Paris, France
Wilde AAM:
Heart Centre AMC, Department of Clinical and Experimental Cardiology, AMC, University of Amsterdam, Amsterdam Netherlands
Brugada P:
Heart Rhythm Management Centre, UZ-VUB, Brussels, Belgium
Kusano KF:
Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
Hirao K:
Heart Rhythm Center, Tokyo Medical and Dental University, Tokyo, Japan
Nam GB:
Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Probst V:
L'institut du Thorax, Service de Cardiologie, CHU de Nantes, Nantes, France
Belhassen B:
Department of Cardiology, Tel Aviv Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Green Submitted
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