Sex differences in cardiac sarcoidosis

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature Pub Date : 2025-08-30 DOI:10.1016/j.ijcha.2025.101777

Katrina A. Williamson , Jenna M. Davison , Andrew N. Rosenbaum , Panithaya Chareonthaitawee , Nikhil Kolluri , John P. Bois , Omar F Abou Ezzeddine , John A. Schirger , Suraj Kapa , Konstantinos C. Siontis , Leslie T. Cooper , Courtney A. Arment

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引用次数: 0

Abstract

Background

Cardiac sarcoidosis (CS) is an inflammatory cardiomyopathy for which sex differences outcomes are not well described.

Objectives

This study aimed to understand differences in CS presentation, complications, and outcomes between females and males.

Methods

Patients meeting Japanese Circulation Society or Heart Rhythm Society criteria for CS were evaluated at a single institution from January 1, 1999, to December 31, 2023 (n = 455). Presenting characteristics including demographics, symptoms, conduction abnormalities, arrhythmias and left ventricular ejection fraction (LVEF) between females and males were compared. Sex-based differences in hospitalizations, LVAD implantation, transplantation and death were analyzed.

Results

The cohort was mostly male (60.7 %). Females presented at an older age (58.5, IQR 51–65 in females, vs 54, IQR 45–61 in males, p = 0.001), and more females experienced palpitations (46.4 %, p = 0.04), chest pain (34.6 % p = 0.02), and fatigue (53.6 % p = 0.01) at presentation. Females had higher New York Heart Association (NYHA) class (III or IV) (31.5 % vs 21.8 %; p = 0.05), and higher NT-proBNP (467 in females vs 257.5 in males, p = 0.03) at presentation. Cardiovascular hospitalization–free survival, LVAD/transplant-free survival, and overall survival were not significantly different.

Conclusions

Females presented at an older age and were more symptomatic with higher NYHA class symptoms than males, suggesting that females are presenting or being diagnosed with CS later than males. LVEF, rates of heart block, and ventricular arrhythmias were similar between sexes, suggesting greater heart failure severity in females with CS may be related to greater left ventricular stiffening or worse valvular disease. Differences in survival outcomes were not significant.

Abstract Image

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心脏结节病的性别差异

背景：心脏结节病（CS）是一种炎症性心肌病，其性别差异的结局尚未得到很好的描述。目的本研究旨在了解女性和男性CS表现、并发症和结局的差异。方法1999年1月1日至2023年12月31日，在同一家机构对符合日本循环学会或心律学会CS标准的患者进行评估（n = 455）。比较男女患者的人口学特征、症状、传导异常、心律失常和左心室射血分数（LVEF）。分析了住院、LVAD植入、移植和死亡的性别差异。结果本组以男性为主（60.7%）。女性发病年龄较大（女性为58.5，IQR为51-65，男性为54，IQR为45-61，p = 0.001），更多女性发病时出现心悸（46.4%,p = 0.04）、胸痛（34.6% p = 0.02）和疲劳（53.6% p = 0.01）。女性就诊时纽约心脏协会（NYHA） III级或IV级较高（31.5% vs 21.8%, p = 0.05）， NT-proBNP较高（女性467 vs男性257.5,p = 0.03）。无心血管住院生存、无LVAD/无移植生存和总生存无显著差异。结论与男性相比，女性出现的年龄更大，NYHA级症状更高，提示女性出现或诊断CS的时间晚于男性。LVEF、心脏传导阻滞率和室性心律失常在两性之间相似，提示CS女性患者心衰严重程度越大，可能与左心室僵硬或瓣膜疾病更严重有关。生存结果的差异不显著。

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来源期刊

IJC Heart and Vasculature Medicine-Cardiology and Cardiovascular Medicine

CiteScore

4.90

自引率

10.30%

发文量

216

审稿时长

56 days

期刊介绍： IJC Heart & Vasculature is an online-only, open-access journal dedicated to publishing original articles and reviews (also Editorials and Letters to the Editor) which report on structural and functional cardiovascular pathology, with an emphasis on imaging and disease pathophysiology. Articles must be authentic, educational, clinically relevant, and original in their content and scientific approach. IJC Heart & Vasculature requires the highest standards of scientific integrity in order to promote reliable, reproducible and verifiable research findings. All authors are advised to consult the Principles of Ethical Publishing in the International Journal of Cardiology before submitting a manuscript. Submission of a manuscript to this journal gives the publisher the right to publish that paper if it is accepted. Manuscripts may be edited to improve clarity and expression.