Quality Of Life In Female Patients Research Articles

MiR-93-5p inhibits ovarian cancer through SLC7A11-mediated-ferroptosis

AimOvarian cancer (OC) is the most lethal gynecological malignancy, which seriously affects the prognosis and life quality of female patients. Therefore, new therapeutic targets and treatments are urgently needed. MethodsExpression levels of miR-93-5p and SLC7A11 and ferroptosis status in paracancerous and tumor tissues were examined and compared. The effect of the miR-93-5p-SLC7A11 regulatory loop on the malignant phenotype as well as the ferroptosis phenotype of SKOV3 cells was assessed. Furthermore, the interaction between miR-93-5p and SLC7A11 was confirmed via rescue experiment. ResultsIn this study, we found that miR-93-5p was lowly expressed in cancer tissues, and suggested that overexpression of miR-93-5p could target SLC7A11 to reduce its expression and promote ferroptosis, thereby inhibiting the malignant biological behaviors such as proliferation, invasion and migration, while knockdown of miR-93-5p restrained ferroptosis and promoting tumor growth. Besides, erastin, as a specific inhibitor of SLC7A11, could target down the expression of SLC7A11, induce the occurrence of ferroptosis, and reverse the effect of knockdown of miR-93-5p. ConclusionsTaken together, our findings disclosed that miR-93-5p increased the level of ferroptosis and inhibited the progression of OC by targeting and inhibiting the expression level of SLC7A11, which was a potential treatment in OC.

Методы коррекции сочетанных форм генитального пролапса лапароскопическим доступом

Aim: to evaluate the efficacy and safety of a combined technique — pectopexy, and the most common — laparoscopic sacrocolpopexy for pelvic organ prolapse correction. Patients and Methods: the study included 32 female patients with a similar nosological form of pelvic organ prolapse. All the subjects were divided into two groups depending on the surgical treatment method. Group 1 (main group) included 14 female patients who had a combined laparoscopic correction of pelvic organ prolapse with transverse and longitudinal fixation of synthetic implants — combined pectopexy. Group 2 (control group) included 18 female patients who underwent sacrocolpopexy. Comprehensive clinical and instrumental examination of female patients was performed before and within 24 months after surgery. Results: there were no intraoperative complications in female patients of both groups. In all cases, the surgical intervention result was recognized as positive both according to the patient assessment and medical researcher assessment. There was a significant improvement in indicators reflecting the central compartment condition (apical prolapse), as well as the anterior and posterior vaginal walls. All female patients showed an improvement in their life quality. The patients also showed positive tendency according to pelvic ultrasound after surgery. No pelvic mesh complications were reported. The parameters of the Pelvic Organ Prolapse Quantification (POP-Q) system assessment did not differ significantly in female patients from both groups 1, 6, 12 and 24 months of follow-up after surgery. Conclusion: based on the obtained follow-up data, correction of central, posterior and partially anterior prolapse was achieved in patients after combined transverse and longitudinal fixation of synthetic implants. Pectopexy is safe and comparable to sacrocolpopexy, which is currently considered the most common surgery, gives a positive effect in correcting pelvic organ prolapse and improves the life quality of female patients. KEYWORDS: genital prolapse, combined laparoscopic surgery, mesh implants, surgical treatment of pelvic organ prolapse, laparoscopic sacrocolpopexy, laparoscopic pectopexy, life quality. FOR CITATION: Pyatkina A.N., Bryunin D.V., Chushkov Yu.V. Laparoscopic correction methods of pelvic organ prolapse. Russian Journal of Woman and Child Health. 2024;7(1):18–25 (in Russ.). DOI: 10.32364/2618-8430-2024-7-1-3.

Comprehensive relationship between disease activity indices, mTSS, and mHAQ and physical function evaluation and QOL in females with rheumatoid arthritis

Rheumatoid arthritis (RA) causes significant physical disability. We comprehensively investigated the relationship between RA disease activity (Disease Activity Score 28-C-reactive protein [DAS28-CRP], Simplified Disease Activity Index [SDAI], and Clinical Disease Activity Index [CDAI]), physical function (10-Meter Walk Test [10 MWT], Timed Up and Go test [TUG], Functional Reach Test [FRT], and Disabilities of the Arm, Shoulder, and Hand [DASH]), and quality of life (QOL) (Short-Form 36 [SF-36®]). We also investigated the relationship between van der Heijde’s modified Total Sharp Score (mTSS), modified Health Assessment Questionnaire (mHAQ), and physical function and QOL assessments. Among 35 female patients with RA, DAS28-CRP correlated solely with DASH (r = 0.376), while SDAI and CDAI did not correlate with physical function. The mTSS-hand roentgenographic evaluation correlated with TUG (r = 0.359), FRT (r = − 0.415), and DASH (r = 0.533) among physical function assessments. The mHAQ correlated with 10 MWT (r = 0.347), TUG (r = 0.356), FRT (r = − 0.420), and DASH (r = 0.646). DAS28-CRP correlated with six of the eight subscales of SF-36®, and mTSS and mHAQ correlated with only one subscale. RA disease activity assessments may not reflect all physical functions and QOL domains of female patients with RA. Evaluating physical function and QOL in female patients with RA is essential.

HGF-modified human umbilical cord mesenchymal stem cells rescue impaired ovarian reserve function in chemotherapy-induced POI rats by improving angiogenesis while decreasing apoptosis and fibrosis in the ovary

Complications caused by Primary ovarian insufficiency (POI), including infertility, osteoporosis, cardiovascular diseases and depression, severely affect the life quality of female patients. Although hormone replacement therapy (HRT) can alleviate some long-term complications, there is still no standard treatment for the restoration of ovarian reserve function. Currently, human umbilical cord mesenchymal stem cells (HUCMSC) transplantation showed considerable treatment effect for POI in both rat model and clinic. To improve the effectiveness of naïve HUCMSC (HUCMSC-Null) treatments on POI, an exogenous gene hepatocyte growth factor (HGF) which promotes follicular angiogenesis in POI ovaries was used to modify HUCMSC. Subsequently, HGF-overexpressed HUCMSC (HUCMSC-HGF) was transplanted into the ovaries of chemotherapy-induced POI Sprague-Dawley (SD) rats to observe the effectiveness on POI improvement and its related mechanisms. Our results showed that when compared with POI and HUCMSC-Null treatment group, HUCMSC-HGF significantly improved ovarian reserve function in POI group, which might be attributed to the decrease of ovarian tissue fibrosis and granulosa cells (GCs) apoptosis, and the increase of ovarian angiogenesis mediated by HGF over-expression. The findings suggest that HGF-modified HUCMSC may present a more superior capacity than HUCMSC alone for the rescue of ovarian reserve function in POI.

METTL16 epigenetically enhances GPX4 expression via m6A modification to promote breast cancer progression by inhibiting ferroptosis

Breast cancer is malignant cancer that severely threatens the life quality of female patients. N6-methyladenosine (m6A) is a prevalent modification of RNA. METTL16 is an important methyltransferase. This work aims to study the role of METTL16 in breast cancer cell death. The expression of METTL16 in clinical breast cancer specimens was analyzed by qPCR assay. The in vitro and in vivo breast cancer cell proliferation was measured by CCK8, colony formation, and xenograft mouse model. Cell ferroptosis was assessed by measuring the accumulation of iron, Fe2+, and lipid ROS. The mechanistic study was performed by RNA degradation, qPCR, and Western blotting assay. METTL16 was overexpressed in tumor tissues from breast cancer patients compared with the para-tumor tissues. Knockdown of METTL16 suppressed in vitro cell proliferation and in vivo tumor growth of breast cancer cells. Meanwhile, METTL16 silencing led to elevated intracellular levels of iron, Fe2+, and lipid ROS, indicating the incidence of ferroptosis. Furthermore, siMETTL16 decreased m6A methylation and enhanced the degradation of GPX4 RNA. METTL16-regulated m6A methylation of GPX4 stimulates proliferation and suppresses ferroptosis of breast cancer cells. Therefore, we concluded that METTL16 epigenetically enhanced GPX4 expression via m6A modification to promote breast cancer progression by inhibiting ferroptosis.

Quality of Life of Bulgarian Breast Cancer Female Patients

BACKGROUND: During recent years, breast cancer is the most commonly diagnosed cancer and the leading cause of cancer death in females worldwide and in Bulgaria as well. The issues of satisfactory individual quality of life (QoL) after treatment represent undoubted interest and contribute to the elaboration and implementation of specific assessment questionnaires and scales. AIM: The objective of the present study was to assess some aspects of the QoL in female patients with breast cancer following successful disease management. MATERIALS AND METHODS: We examined a total of 57 female breast cancer patients operated on between 2018 and 2020 at a mean age of 47.89 ± 6.71 years (range, 30–59 years). They filled in the upper limb lymphoedema QoL questionnaire containing 27 items. RESULTS: There was a significant prevalence of the ductal carcinoma and nonspecific invasive carcinoma, of the luminal B- human epidermal growth factor receptor-2 (HER2) positive and luminal B-HER2 negative breast cancer as well as of grade two of differentiation. The responses with “not at all” dominated concerning the domains of “activities of daily living” and “health-related complaints. There was a great variety of the frequency of different patient’s responses to one and the same question when all 27 questions of all 57 patients were assessed as a whole. There was only one response with suffering “a lot” given to all the four items dealing with health-related complaints. The response with “a little” inclination dominated concerning the psychological dimension. The responses with “a lot” disturbance in terms of three items (“in your emotional life with your partner”, “look at yourself in a mirror” and “in your professional relationships”) considerably prevailed indicating the pronounced unfavourable influence on these patients’ quality of social life exerted by the breast cancer. CONCLUSION: Breast cancer moderately affects individual patient’s QoL following successful treatment. Future research using additional specific questionnaires and focusing on the emotional and social aspects of the QoL could contribute to the improvement of patient’s life characteristics.

Association of Traditional Chinese Medicine Body Constitution and Health-Related Quality of Life in Female Patients with Systemic Lupus Erythematosus: A Cross-Sectional Study.

Background Traditional Chinese medicine (TCM) body constitution has been studied in many diseases, but few have focused on systemic lupus erythematosus (SLE) and particularly their association with disease-specific quality of life (QoL). Therefore, the aim of this study was to investigate the association of TCM body constitution and QoL in female patients with SLE. Methods A cross-sectional study was conducted on adult female patients with a clinician-confirmed diagnosis of SLE in a regional hospital in Taiwan. TCM body constitution types were determined using the Constitution in Chinese Medicine Questionnaire (CCMQ). Disease-specific QoL of the participants was assessed using the LupusQoL. Multiple linear regression analyses were conducted to assess the associations between TCM body constitution types with the score of each of the eight domains of LupusQoL and between the numbers of multiple unbalanced body constitution types and score of each of the eight domains of LupusQoL. Results Of the 317 female patients with SLE, 22 (6.9%) were classified to have a gentleness balanced body constitution type. Among the remaining 295 patients with unbalanced body constitution types, Qi-deficiency was the most common (64.4%), followed by Yin-deficiency (57.6%). Multiple linear regression analyses showed that Qi-deficiency was significantly associated with the emotional, pain, and fatigue domains of the LupusQoL, whereas Yin-deficiency was significantly associated with the emotional and fatigue domains of the LupusQoL. In addition, all domains of the LupusQoL showed a general pattern of poorer QoL with increasing numbers of unbalanced body constitution types. Conclusions Different TCM body constitution types were significantly associated with various domains of the LupusQoL. A high prevalence of multiple body constitution types in patients with SLE was observed. A consistent pattern of poorer LupusQoL with increasing numbers of unbalanced body constitution types was evident.

Quality of life and post-traumatic stress disorder among adult females with cancer in Palestine: a cross-sectional study

ABSTRACT Background: Little research has been conducted on the quality of life (QoL), functional status, and traumatic symptoms related to the diagnosis and treatment of cancer in the Arab region, particularly in Palestine, where the psychological problems in patients with cancer are often neglected. Objective: The aim of the study was to assess QoL and post-traumatic stress disorder (PTSD) symptoms among adult female patients with cancer attending Beit-Jala Governmental Hospital in Bethlehem. Method: Participants were recruited from 4 April 2015 to the end of July 2015. The sample included 253 female patients with cancer attending Beit-Jala Governmental Hospital in Bethlehem. Data were collected using self-reported questionnaires, including a socio-demographic data sheet, the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30, and the post-traumatic stress disorder checklist for PTSD symptoms. Results: The current study showed poor global QoL (57.4%) and poor physical function (48.5%) for female patients with cancer. Insomnia, fatigue, and loss of appetite were the most troublesome symptoms that the participants complained about. The prevalence of PTSD symptoms was 3%. Regarding PTSD symptom severity, 2% reported severe symptoms, 23.3% reported moderate symptoms, and (68.8%) reported mild symptoms, based on a 1991 classification of PTSD symptom severity scores. Finally, Pearson’s test revealed a strong, statistically significant, inverse relationship between QoL domains and PTSD. Conclusion: The study found that the overall QoL of female patients with cancer was low and strongly associated with PTSD symptoms, suggesting that early detection and treatment of these symptoms is critical.

Relationship Between Social Capital and Life Quality of Female Patients with High Blood Pressure in Health Centers of Khalkhal in Iran

Background: High blood pressure has become a major problem in developing countries. A method of controlling blood pressure is to improve the life quality of patients. Studies have emphasized the importance of examining the role of social capital in patients’ quality of life. The present study aimed to investigate the relationship between social capital and life quality of female patients with high blood pressure. Materials and Methods: The present correlative study was carried out using the survey method. The statistical population included all women referring to the health centers of Khalkhal in Iran with care reports within January 2018 to December 2019. The current study was carried out on a total of 3,684 individuals. The sample size consisted of 357 female patients with high blood pressure who were determined using Cochran’s formula and random sampling technique. In addition, to compare high blood pressure patients with other individuals, 357 subjects were selected from other referrals as the study subjects. The data collection tool was a researcher-designed questionnaire for social capital and 36-Item Short Form Survey (SF-36) for life quality. Moreover, the data were analyzed using Pearson’s correlation coefficient and t-test by SPSS software (version 22). Results: The obtained results of the current study showed that there was a significant relationship between social capital dimensions (i.e., social trust, social support, strong relationship, and associative membership) and life quality of patients with hypertension (P<0.05). It was also indicated that the average social capital of healthy individuals was higher than that reported for those with high blood pressure (P<0.05). Conclusion: By increasing social capital in patients with hypertension, their quality of life will improve.

The influence of various anesthetic thechniques on life quality of patients during the postoperative period after curettage of the uterine cavity

Curettage of uterine cavity (CUC) is an informative diagnostic and treatment method, which is widely applied in gynecology of one day. However, its low injury rate is not able to exclude completely the development of postsurgical pain syndrome, consequently changing the life quality of patients. The occurrence of psychosomatic effects is influenced by the underlying disease, concerning which the manipulation was performed, the psycho-emotional atmosphere of the hospital, the intensity of the pain syndrome, etc. Objective : to define the range of clinically significant changes of life quality after outpatient endouteral operational interventions, and to evaluate the influence of components of anesthesia service, which have the greatest influence on changing life quality of female patients in the early postoperative period. Materials and methods : during the postoperative period the interviewing of patients was conducted with the use of scale enquirer of life quality EQ-5D, “Enquirer of life quality of patients during the postoperative period” and with the use of visual analogue scale (VAS), statistical processing of received data was also performed. Results : the conducted research identified prime factors of influence over life quality of patient in pre- and postoperative period of CUC, rational methods of improving life quality after CUC. These are physical (postoperative pain syndrome) and psychological (fear of future surgery, nervousness regarding its carrying-out, its results and expectation of pain during operative intervention) factors. Conclusions : the prime factor, which has notional influence on life quality in the postoperative period of CUC, is a disorder of emotional-volitional sphere, albeit in imperceptible intensity, however in statistically significant feeling jittery and mental depression, caused by fear of women before the upcoming operational intervention, peculiarities of its performance and results, as well as the quality of anesthesia service. In the postoperative period of CUC the greatest influence on life quality of patients has the postsurgical pain syndrome. A method of preventive intraoperative anesthesia allows to prevent the development of pain syndrome in an efficient and timely manner, and thus goes into efficient way of improving life quality of patients of gynecologic hospital of one day in the postoperative period of endouteral operational interventions. Research results have also found out a circumstantial positive influence of the indicated method of anesthesia on the characteristics of emotional state and a possibility to prevent disorders in emotional-volitional sphere of female patients

Mutual associations between patients' and partners' depression and quality of life with respect to relationship quality, physical complaints, and sense of coherence in couples coping with cancer.

The aim of this article is to examine the mutual associations between patients' and partners' depression and quality of life (QOL) in couples facing cancer with respect to potential resources (sense of coherence and relationship quality (RQ)) and stressors (physical complaints). Questionnaires rating depression, QOL, sense of coherence, RQ, and physical complaints were completed by 207 couples facing different cancer types and stages. Multiple regression models were used to assess the mutual associations between patient and partner variables. In female patients, 40.7% of the variance in depression score was explained by male partners' stressors and resources, whereas only 3.5% of the variance in male patients' depression was explained by female partners' stressors and resources. In male and female partners, respectively, the patients' stressors and resources explained 34.9% versus just 15.8% of the variance in depression. Regarding QOL in female patients, 30.1% of the variance was explained by the partners' stressors and resources, versus only 3.7% in male patients. Meanwhile, in male and female partners, respectively, the patients' stressors and resources explained 25.6% and 12.9% of the variance in QOL. These findings support a couples-centered approach to psycho-oncological counseling and treatment. Particularly in depressed couples with low RQ, couples therapy or counseling should be considered because of the mutual adverse association between depression and QOL in these couples.

What are the predictors of quality of life of people with epilepsy?

The article, “Determinants of quality of life among people with epilepsy attending a secondary care rural hospital in south India,”[1] explores quality of life (QOL) of people with epilepsy attending the outpatient department of a secondary care hospital. The main aim of the study was to determine the various social and demographic factors affecting it. Medical factors, such as kind of epilepsy or requency of seizures, were not taken into account in the study and this fact may have negatively influenced the interpretation of some of the results obtained. On the other hand, the article contains some interesting findings, which deserve a further discussion. First, the authors found that QOL of women is statistically significantly lower than QOL of men. It may be connected with the finding that all patients in the study used single or even poly antiepileptic drugs (AEDs). It had been reported that perceived side effects of AEDs and number of AEDs simultaneously used strongly predict QOL in female patients, whereas these factors play only a minor role in QOL of male patients.[2] A plausible explanation may be that fertile female patients with epilepsy worry about increased risks of miscarriage, congenital malformations, prenatal death, and cognitive impairments of the child resulting from exposure to AEDs. Although the study we are commenting on reports that the effect of medication is not significant, it would be interesting to check whether the reported difference in QOL between men and women is actually due to medication use. Second, the authors found that currently married patients exhibit on average significantly lower QOL compared with unmarried patients. It is quite a surprising finding because a review article devoted to predictors of QOL in patients with refractory mesial temporal lobe epilepsy[3] reported that marital status had mostly not been found to be a statistically significant predictor or had even been found to have a positive association with QOL. This difference between the study being commented on and a number of other studies may be due to the instrument used to determine QOL. It is possible that the WHOQOL-BREF instrument used in the study being commented on laid stress on other aspects of QOL related to marital status than instruments such as QOLIE 31, QOLIE 89, etc., typically used in studies cited in.[3] Finally, the authors found that younger patients exhibit on average higher QOL compared with older patients. It is in good agreement with the findings about negative effect of age on social functioning and cognitive functioning of people with epilepsy reported in the literature.[4,5] On the other hand, age might be an important predictor of QOL for another reason. It was reported[6] that duration of the epilepsy, which was not investigated in the study being commented on, is a very important factor negatively affecting QOL. The duration of epilepsy is usually strongly correlated with age. Thus, it raises the question whether duration of epilepsy is a more important factor than age, and, consequently, what is QOL of older people with a later onset, and hence a lower duration, of epilepsy. The main aim of this commentary is to demonstrate how complex and complicated the topic of QOL is. There are many mutually coupled factors and sometimes it is very difficult to determine which of them are the driving factors because it is possible to find several different reasonable interpretations of the data obtained. In order to overcome such difficulties it is necessary (i) to characterize very carefully the studied sample of the patients by all relevant medical, sociodemographic, and other factors and (ii) to develop new QOL instruments with superior psychometric properties, which would minimize the probability that some very important factor would be classified by the statistical analysis as not so important due to its shielding by other factors. In our opinion, this is the way to learn more about this topic in the future.

Efficacy of Propiverine in Improving Symptoms and Quality of Life in Female Patients with Wet Overactive Bladder

Objectives: The present prospective study was conducted to assess the effects of propiverine hydrochloride in improving symptoms and quality of life (QoL) in female patients with wet OAB.Methods: Propiverine was administered orally for 8 weeks to 58 female patients who had urgency incontinence. Prior to administration, and at 4 and 8 weeks after administration, symptoms and QoL of the patients were assessed using a micturition diary, the International Consultation on Incontinence Questionnaire‐Short Form (ICIQ‐SF), and the King's Health Questionnaire (KHQ). In addition, the relationships between changes in frequency of urinary incontinence or amount of urine leakage following treatment and changes in each domain of the KHQ were investigated by multiple regression analysis.Results: After administration of propiverine, the mean numbers of daily micturitions, incontinence episodes, and urgency episodes assessed on the basis of the micturition diary significantly improved in comparison to the baseline: from 11.7 to 9.6 for daily micturitions, from 2.8 to 1.1 for incontinence episodes, and from 5.9 to 2.3 for urgency episodes in 8 weeks. The mean of the ICIQ‐SF total scores significantly decreased, from 8.4 to 4.6 points at 4 weeks and to 3.6 points at 8 weeks. The mean scores for three individual items in the ICIQ‐SF, namely, frequency of incontinence episodes, amount of leakage, and impact on everyday life also significantly improved. The KHQ scores significantly improved at both 4 and 8 weeks post‐administration in all domains except personal relationships. In the multiple regression analysis, improvement in frequency of incontinence was significantly related to the domain of severity measure of the KHQ, while improvement in amount of leakage was significantly related to the domains of general health perception and social limitations.Conclusion: Propiverine hydrochloride contributed to improvements not only in symptoms but also in QoL in female patients with wet OAB.

Hand eczema severity and quality of life: a cross‐sectional, multicentre study of hand eczema patients

Hand eczema is a chronic disease with negative impact on quality of life (QoL). In this study, QoL in hand eczema patients is assessed and related to age, sex, severity, and diagnostic subgroups. A total of 416 patients with hand eczema from 10 European patch test clinics participated in the study. Data on QoL were obtained from a self-administered questionnaire using the Dermatology Life Quality Index (DLQI). Severity was assessed by a scoring system (Hand Eczema Severity Index, HECSI) as well as frequency of eruptions and sick leave due to hand eczema. No significant difference was found between males and females with respect to QoL [DLQI median values and 25/75 percentiles for males and females being 7.0 (3-14) and 8.0 (3-13), respectively], although males were more severely affected than females (P < 0.025). A significant positive correlation was found for hand eczema severity and age (P < 0.001), while no significant correlation was found for QoL and age. QoL was found increasingly reduced when sick leave was getting higher (P < 0.001). A statistically significant correlation between QoL (as measured by DLQI) and hand eczema severity as measured by HECSI was found (P < 0.001). No significant difference in QoL was found between diagnostic subgroups. QoL was found markedly negatively affected in hand eczema patients and was significantly correlated to disease severity. No significant difference in QoL was found between males and females, in spite of significantly more severe eczema in males, indicating that QoL in female patients is more easily affected.

Gender-Related Differences in Rhythm Control Treatment in Persistent Atrial Fibrillation: Data of the Rate Control Versus Electrical Cardioversion (RACE) Study

This study sought to compare whether gender affects the outcome of rate versus rhythm control treatment in patients with persistent atrial fibrillation (AF). Large trials have shown that rate control is an acceptable alternative to rhythm control. However, the effects of treatment may differ between male and female patients. In the Rate Control versus Electrical Cardioversion (RACE) study, 522 patients (192 female) were included and randomized to rate or rhythm control. The occurrence of cardiovascular end points and quality of life (QoL) were compared between female and male patients. At baseline, female patients differed from male patients with regard to age, underlying heart disease, diabetes mellitus, and left ventricular function. Female patients had more AF-related complaints, and QoL was significantly lower. After a mean follow-up of 2.3 +/- 0.6 years, cardiovascular morbidity and mortality was equally distributed between female (21%) and male patients (19%). However, in contrast to male patients, female patients randomized to rhythm control developed more end points (adjusted hazard ratio was 3.1 [95% confidence interval 1.5 to 6.3], p = 0.002), mainly heart failure, thromboembolic complications, and adverse effects of antiarrhythmic drugs, compared with rate control randomized female patients. During follow-up, QoL in female patients remained worse compared with that for male patients. Randomized strategy did not influence QoL in female patients. In female patients with persistent AF, a rhythm control approach leads to more cardiovascular morbidity and mortality. Because treatment strategy did not influence QoL in female patients, a rate control approach may be considered in these patients.