Hussein Abdul Nabi , George Bcharah , Luke Dreher , Hend Bcharah , Mahmoud Abdelnabi , Ramzi Ibrahim , Fares Jamal , Amal Youssef , Linnea M. Baudhuin , Yuxiang Wang , Mayowa A. Osundiji , Fadi E. Shamoun
{"title":"Sex-based differences in patients with Loeys-Dietz syndrome: An analysis of arteriopathies and surgical interventions","authors":"Hussein Abdul Nabi , George Bcharah , Luke Dreher , Hend Bcharah , Mahmoud Abdelnabi , Ramzi Ibrahim , Fares Jamal , Amal Youssef , Linnea M. Baudhuin , Yuxiang Wang , Mayowa A. Osundiji , Fadi E. Shamoun","doi":"10.1016/j.ijcard.2025.133477","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Loeys-Dietz syndrome (LDS) is a rare connective tissue disorder caused by variants in genes like TGFBR1, TGFBR2, TGFB2, TGFB3, and SMAD3, leading to vascular abnormalities such as aneurysms and dissections. This study examines sex-based differences in the clinical presentation of LDS, focusing on comorbidities, physical exam findings, vascular events, and surgeries.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on 94 LDS patients (47 males and 47 females) at Mayo Clinic locations in Arizona, Rochester, and Florida. Data were collected from chart reviews, including comorbidities, physical exam findings, vascular events, and surgeries. Statistical analysis included Chi-square tests to compare the two groups.</div></div><div><h3>Results</h3><div>Among the cohort, females had higher rates of obesity (23.4 % vs. 8.5 %, <em>p</em> = 0.049) and migraines (44.7 % vs. 21.3 %, <em>p</em> = 0.027). Females also had more easy bruising (31.9 % vs. 8.5 %, <em>p</em> = 0.005), while dolichocephaly was more common in males (21.3 % vs. 6.4 %, <em>p</em> = 0.036). Males had more aneurysms and dissections, including ascending aortic (89.4 % vs. 72.3 %, p = 0.036) and abdominal aortic aneurysms (34 % vs. 10.6 %, <em>p</em> = 0.006), and aneurysms in other locations (63 % vs. 42.6 %, <em>p</em> = 0.048). Type A and B aortic dissections were also more common in males (21.3 % vs. 6.4 %, <em>p</em> = 0.036). Males had more aortic root replacements (74.5 % vs. 53.2 %), while females had more tricuspid valve repairs (19.1 % vs. 2.1 %, <em>p</em> = 0.007).</div></div><div><h3>Conclusion</h3><div>This study highlights significant gender differences in LDS, particularly in vascular events and surgical interventions. Males are more likely to experience aneurysms and dissections and undergo aortic root replacement. These findings stress the importance of considering sex-based factors in LDS management.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"437 ","pages":"Article 133477"},"PeriodicalIF":3.2000,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International journal of cardiology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0167527325005200","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Background
Loeys-Dietz syndrome (LDS) is a rare connective tissue disorder caused by variants in genes like TGFBR1, TGFBR2, TGFB2, TGFB3, and SMAD3, leading to vascular abnormalities such as aneurysms and dissections. This study examines sex-based differences in the clinical presentation of LDS, focusing on comorbidities, physical exam findings, vascular events, and surgeries.
Methods
A retrospective analysis was conducted on 94 LDS patients (47 males and 47 females) at Mayo Clinic locations in Arizona, Rochester, and Florida. Data were collected from chart reviews, including comorbidities, physical exam findings, vascular events, and surgeries. Statistical analysis included Chi-square tests to compare the two groups.
Results
Among the cohort, females had higher rates of obesity (23.4 % vs. 8.5 %, p = 0.049) and migraines (44.7 % vs. 21.3 %, p = 0.027). Females also had more easy bruising (31.9 % vs. 8.5 %, p = 0.005), while dolichocephaly was more common in males (21.3 % vs. 6.4 %, p = 0.036). Males had more aneurysms and dissections, including ascending aortic (89.4 % vs. 72.3 %, p = 0.036) and abdominal aortic aneurysms (34 % vs. 10.6 %, p = 0.006), and aneurysms in other locations (63 % vs. 42.6 %, p = 0.048). Type A and B aortic dissections were also more common in males (21.3 % vs. 6.4 %, p = 0.036). Males had more aortic root replacements (74.5 % vs. 53.2 %), while females had more tricuspid valve repairs (19.1 % vs. 2.1 %, p = 0.007).
Conclusion
This study highlights significant gender differences in LDS, particularly in vascular events and surgical interventions. Males are more likely to experience aneurysms and dissections and undergo aortic root replacement. These findings stress the importance of considering sex-based factors in LDS management.
期刊介绍:
The International Journal of Cardiology is devoted to cardiology in the broadest sense. Both basic research and clinical papers can be submitted. The journal serves the interest of both practicing clinicians and researchers.
In addition to original papers, we are launching a range of new manuscript types, including Consensus and Position Papers, Systematic Reviews, Meta-analyses, and Short communications. Case reports are no longer acceptable. Controversial techniques, issues on health policy and social medicine are discussed and serve as useful tools for encouraging debate.