Adult congenital heart disease in women: demographics and outcomes in mexico. gender differences?

Abstract

Abstract Background Due to advances in cardiovascular medicine in recent decades, adult congenital heart disease (ACHD) is becoming a growing field in cardiology. Differences in clinical presentation, treatment, and outcomes of ACHD between men and women have not been well studied in Latin America and Mexico. Purpose To characterize gender differences in clinical presentation, treatment, and mortality of ACHD in Mexico. Methods From January 2006 to December 2020, 3503 patients with ACHD were studied at a cardiology national reference center in Mexico. SPSS V. 23 software was used for statistical analysis. Results Women comprised 56% of the study population, in which a higher percentage of pulmonary hypertension and Eisenmenger syndrome was observed, (10.9% men vs. 17.7% women; 1.5% men vs. 3.3% women, p <0.01). Women had a higher score in AHA´s physiological classification (State C, 27.9% men vs. 35.3% women, p <0.01). Men had a higher rate of severity/anatomic complexity (13.3% men vs. 11.7% women, p <0.01), a higher rate of LVEF <40%, (8.0% men vs. 23.8% women, p <0.01), and underwent total repair surgery more often (61.3% men vs. 57% women, p <0.01). No statistical difference was observed in functional class, presence of arrhythmias, or mortality (patient´s current status). Figure 1. Conclusions We found gender differences in ACHD in Mexico: women were more likely to have pulmonary hypertension, which may reflect the already known gender predilection of PH; additionally, women had a higher AHA's physiological score; despite this, women underwent complete surgery less frequently. Although men had higher anatomic complexity and a lower LVEF, there was no statistical difference in functional class or mortality.Figure 1