三尖瓣返流(TR)是一种心脏疾病,血液通过三尖瓣向后流动。三尖瓣疾病是一种主要的心脏瓣膜病,由于量身定制的治疗方案和治疗结果的性别差异,引起了人们的高度关注。这项研究旨在调查生物性别是否对发育有重大影响,programming,和成人三尖瓣疾病的治疗结果。我们进行了全面的搜索,以确定研究性别对TR病理生理学的影响以及TR患者的治疗结果。我们搜索了PUBMED/MEDLINE,Scopus,和ExcerptaMedica数据库(EMBASE)从开始到2023年9月,以确定相关研究。12项研究共22,574名患者符合我们的资格标准。这些研究分为三个亚组:无干预的TR患者(3,848名患者,男性占48.1%,女性占51.9%),那些接受心脏直视手术(17,498例患者:男性46.2%,女性53.8%),以及接受经导管三尖瓣修复/置换的患者(TTVR;1,687例患者:男性占41.6%,女性占58.4%)。分析显示,在TR病因方面没有重大差异。男性倾向于具有略低的平均年龄差异(平均差异(MD):-0.60岁;95%置信区间(CI)(-1.49,-0.04);p=0.10),但患有更频繁的慢性肺病(风险比(RR):1.12,95%CI(1.01,1.25),p=0.03)。男性显示较高的基线TR体积(MD:4.11,95%CI(0.53,7.68),p=0.02)和较低的左心室射血分数(MD:-5.85,95%CI(-6.97,-4.73),p<0.00001)。在进行TR治疗的心脏直视手术后,男性需要更频繁的永久性起搏器植入(PPM;RR:1.57,95%CI(1.21,2.03),p=0.0006)。同样,TTVR显示男性对PPM的需求较高(RR:1.45,95%CI(1.10,1.93),p=0.010)。住院死亡率没有性别差异,但男性的晚期死亡风险略有升高.TR患者的性别差异在基线特征上是显著的,男性患某些疾病的风险更高。就预后而言,对PPM的更频繁要求是基于性别的主要差异。
Tricuspid regurgitation (TR) is a heart condition where blood flows backward through the tricuspid valve. Tricuspid valve disease constitutes a major valvular heart condition that is receiving heightened attention due to tailored treatment options and sex-specific differences in treatment outcomes. The study aims to investigate whether biological sex has a significant influence on the development, progression, and treatment outcomes of tricuspid valve disease in adults. We conducted a comprehensive search to identify studies examining the impact of sex on the pathophysiology of TR as well as treatment outcomes in patients with TR. We searched PUBMED/MEDLINE, SCOPUS, and Excerpta Medica dataBASE (EMBASE) from inception to September 2023 to identify relevant studies. Twelve studies totaling 22,574 patients met our eligibility criteria. These studies were categorized into three subgroups: patients with TR without intervention (3,848 patients, with 48.1% males and 51.9% females), those who underwent open heart surgery (17,498 patients: 46.2% males and 53.8% females), and those who underwent transcatheter tricuspid valve repair/replacement (TTVR; 1,687 patients: 41.6% males and 58.4% females). Analysis revealed no major differences in terms of TR etiology. Males tended to have a slightly lower mean age difference (mean difference (MD): -0.60 years; 95% confidence interval (CI) (-1.49, -0.04); p = 0.10) but had more frequent chronic lung disease (risk ratio (RR): 1.12, 95% CI (1.01, 1.25), p = 0.03). Males showed higher baseline TR volume (MD: 4.11, 95% CI (0.53, 7.68), p = 0.02) and lower left ventricular ejection fraction (MD: -5.85, 95% CI (-6.97, -4.73), p < 0.00001). Following open heart surgery for TR treatment, males required more frequent permanent pacemaker implantation (PPM; RR: 1.57, 95% CI (1.21, 2.03), p = 0.0006). Similarly, TTVR showed a higher need for PPM in males (RR: 1.45, 95% CI (1.10, 1.93), p = 0.010). In-hospital mortality exhibited no sex differences, but males had a slightly elevated late mortality risk. Sex differences in TR patients were notable in baseline characteristics, with males having a higher risk of certain conditions. The more frequent requirement for PPM was a major sex-based difference in terms of prognosis.