부산대학교 도서관

Background Prior studies have demonstrated significantly lower rate of mortality and appropriate primary prevention implantable cardioverter defibrillator (ICD) therapy in female non-ischemic cardiomyopathy (NICM) compared to men. However, the sex specific mechanisms of protective risk in women are unclear. Therefore, we sought to compare morphologic and tissue characteristic features of NICM patients who underwent cardiac magnetic resonance (CMR) prior to ICD implantation and risk of ventricular arrhythmia and mortality based on sex.Methods: NICM patients who underwent prior CMR within 1 year of ICD implantation between 2002 and 2018 were evaluated. Cox and Fine-Gray models were used to compare event-free survival as appropriate. Clinical characteristics; left atrial volume; ventricular volume, function and remodeling; and late gadolinium enhancement derived from CMR were evaluated with simple t test and chi square analysis to determine their predictive value.Results: We identified a total of 311 patients (118 (37.9% female), median age 65) who met our inclusion criteria. Despite similar scar percentage and LVEF between both genders (p = 0.26, p= 0.62, respectively), females demonstrated significantly lower risk of all-cause mortality/LVAD/transplant in comparison to males (HR 0.48, CT 0.27-0.87; P = 0.016). There was a trend towards lower risk of appropriate ICD therapy in females, (HR 0.54, CI 0.28-1.01; P = 0.055). Comparison of morphologic and functional measures based on sex are listed in Table.Conclusions: Female NICM patients who underwent primary prevention ICD implantation experienced significantly lower mortality/LVAD/transplant rates compared to men, despite similar LVEF and scar burden. Sex differences in ventricular/atrial volumes and function, as well as relative wall thickness, may provide insights into underlying mechanisms of protective effects.