P970 Female gender predicts longer survival despite higher age at pacemaker implantation

2003 ◽  
Vol 24 (5) ◽  
pp. 163
Author(s):  
M BRUNNER
Keyword(s):  
Pacemaker Implantation ◽  
Female Gender

P1788The outcome of TAVI in patients with small annulus and the comparison between intra-annular and supra-annular devices in small anulus: From the analysis of the Japanese nationwide registry

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K Meguro ◽  
T Hashimoto ◽  
T Yanagisawa ◽  
T Kitamura ◽  
J Ako
Keyword(s):  
Pressure Gradient ◽  
Pacemaker Implantation ◽  
Female Gender ◽  
Aortic Annulus ◽  
Effective Orifice Area ◽  
Femoral Access ◽  
Paravalvular Leakage ◽  
Mean Pressure ◽  
Asian People ◽  
Small Annulus

Abstract Background Transcatheter aortic valve implantation (TAVI) has been widely accepted strategy of the treatment for aortic stenosis in patients at intermediate to high or prohibitive surgical risk. The Asian people are of smaller body size compared to Western people. As the result, Asian people have smaller aortic annulus size, which accommodate only smaller transcatheter heart valves (THVs), however, the details and consequences of small aortic annulus size in TAVI is uncertain. Purpose The purposes of this study were to clarify the short-term outcomes of TAVI in patients with small annulus and the differences of intra-annular and supra-annular THVs in small annulus using Japanese national TAVI registry. Methods Multi-detector computed tomography (MDCT) was performed before TAVI and the annulus area was registered. We compared the 30-day clinical outcomes between patients with and without small annulus (annulus area 3.14cm2). Further investigation to compare intra-annular and supra-annular THVs in patients with small annulus was conducted. Results The total of 5,870 patients (103 sites in Japan) who underwent TAVI between August 2013 to December 2017 were enrolled in this study. Out of 5,870 patients, 647 had small annulus. Thirty-day mortality, new pacemaker implantation and stroke rate were comparable between patients with and without small annulus. Echocardiography within 30 days after TAVI revealed that patients with small annulus had significantly smaller indexed effective orifice area (iEOA, 1.10.cm2/m2 [0.92–1.35] vs. 1.16 cm2/m2 [0.96–1.39], p<0.001), higher mean pressure gradient (10.0 mmHg [6.9–14.2] vs. 8.5 mmHg [6.0–11.5], p<0.001) and lower frequency of paravalvular leakage moderate (17.3% vs. 24.4%, p<0.001). Patient-prosthesis mismatch (PPM) were more frequent in patients with small annulus (p=0.002). Logistic regression analysis revealed that small annulus (OR: 1.82; 95% CI: 1.45–2.30, p<0.001), female gender (OR: 0.54; 95% CI: 0.42–0.70, p<0.001), weight (OR: 1.03; 95% CI: 1.02–1.04, p<0.001), height (OR: 1.04; 95% CI: 1.02–1.05, p<0.001), hyperlipidemia (OR: 1.25; 95% CI: 1.07–1.47, p=0.006), femoral access (OR: 0.80; 95% CI: 0.66–0.97, p=0.026) were significantly associated with the PPM after TAVI. The use of SAPIEN 3 20mm THV in patients with small annulus was associated with the smaller iEOA (0.94 cm2/m2 [0.78–1.06] vs. 1.07 cm2/m2 [0.84–1.24], p=0.001) and higher mean pressure gradient (14.0 mmHg [10.0–18.5] vs. 11.0 [7.0–14.0], p<0.001) compared to the usage of Evolut R 23 mm THV. The rate of paravalvular leakage more than moderate was similar in both THVs (14.4% vs. 16.5%, p=0.69). Conclusions Small annulus did not affect clinical 30-day outcomes, however, small annulus was associated with smaller iEOA and higher mean pressure gradient. Supra-annular device might contribute the better hemodynamical improvement in patients with small annulus without increase of paravalvular leakage. Acknowledgement/Funding None

Gender-role orientation and social expectations regarding female adolescents' coping with developmental tasks 1The preparation of this article was facilitated by a grant from the Swiss National Foundation for young researchers, financed by the local research committee of the University of Fribourg to the first author during her stay at the University of Illinois at Urbana-Champaign, USA. We are grateful to Susan B. Cleary for editing the English version of this article.

1999 ◽  
Vol 58 (4) ◽  
pp. 273-286 ◽  
Author(s):  
Regula P. Berger ◽  
Alexander Grob ◽  
August Flammer
Keyword(s):  
Gender Role ◽  
Female Gender ◽  
Role Orientation ◽  
Developmental Tasks ◽  
Developmental Task ◽  
Gender Role Orientation ◽  
Research Committee ◽  
National Foundation ◽  
Normative Expectations ◽  
The University

This study focuses on the importance of social developmental expectations, assessed as emotional and cognitive evaluations regarding the timing and the gender-role conformity of normative developmental tasks. Two central questions were raised. First, to what degree do the timing and the gender-role conformity affect the adults' expectations? Second, how much does the adults' own gender-role orientation (GRO), classified as traditional vs. liberal, affect their expectations? A 4 (timing modus) × 2 (developmental task) × 2 (gender-role conformity)-factorial design was administered to a sample of 140 adults of both sexes, 20 to 81 years old. Coping in time and with gender-role typical career received the most approval. Typical developmental tasks were more approved by persons with a traditional than with a liberal GRO. However, the evaluation of non-typical developmental tasks was not affected by the GRO. The possibility of a shift in normative expectations toward more liberal, diverse, and self-defined female gender-roles is discussed.

Vitamin D Deficiency in Patients with Acute Myocardial Infarction: An Italian Single-Center Study

2015 ◽  
Vol 85 (1-2) ◽  
pp. 23-30 ◽  
Author(s):  
Aneta Aleksova ◽  
Rita Belfiore ◽  
Cosimo Carriere ◽  
Salam Kassem ◽  
Salvatore La Carrubba ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Primary Source ◽  
Sun Exposure ◽  
Female Gender ◽  
Developed Countries ◽  
Vitamin D Status ◽  
High Exposure

Abstract. Background: Hypovitaminosis D is a vitamin deficiency that has been increasing in developed countries; it was also suggested as an emerging risk factor for developing of atherosclerosis and acute myocardial infarction. The primary source of vitamin D is its cutaneous synthesis under exposure to sunlight. It has been suggested that 30 min of sun exposure twice weekly leads to sufficient vitamin D synthesis. The residents of Trieste (Italy) are well-known for their high exposure to sunlight in all seasons. We aimed to investigate the vitamin D status in subjects with acute myocardial infarction living in this area. Methods: Vitamin D status was identified in 478 subjects diagnosed with acute myocardial infarction. Results: The median serum 25-hydroxyvitamin D concentration was 14.5 [7.8 - 22.7] ng/mL. Vitamin D deficiency and insufficiency were present in 324 (68 %) and 107 (22 %) subjects, respectively. Vitamin D deficiency was less frequent among subjects enrolled in the period from July to the end of September (p < 0.001). In a multivariate analysis vitamin D deficiency was predicted by older age (p = 0.02), female gender (p = 0.002), higher body mass index (p = 0.05), autumn/winter sampling (p < 0.001), increased parathyroid hormone (p = 0.03) and alkaline phosphatase (p = 0.003). Conclusions: We observed very high prevalence of vitamin D deficiency among subjects with myocardial infarction in all seasons of enrollment. However, it was lower in the summer when sun exposure is higher. The exposure to sunlight may be a cost-saving therapeutic strategy for the management of vitamin D deficiency.

Female gender: is it dangerous to your health?

2010 ◽  
Vol 58 (S 01) ◽  
Author(s):  
B Nitsch ◽  
T Zietak ◽  
R Uhl ◽  
M Thoma ◽  
L Günkel ◽  
...  
Keyword(s):  
Female Gender

Prosthesis-Patient Mismatch Causes a Significantly Increased Risk of Operative Mortality in Aortic Valve Replacement

2014 ◽  
Vol 17 (3) ◽  
pp. 127 ◽  
Author(s):  
Muhammad Shahzeb Khan ◽  
Faizan Imran Bawany ◽  
Asadullah Khan ◽  
Mehwish Hussain
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Operative Mortality ◽  
Univariate Analysis ◽  
Female Gender ◽  
Valve Prosthesis ◽  
Predictors Of Mortality ◽  
Increased Risk ◽  
Urgent Operation

<p><b>Background:</b> Small aortic prosthesis can lead to prosthesis-patient mismatch (PPM). Implanting such small prosthesis remains a controversial issue. This study was done to investigate whether or not PPM causes an increased operative mortality in aortic valve replacement (AVR).</p><p><b>Methods:</b> Two-hundred-two consecutive patients undergoing primary AVR in a tertiary hospital were included. The sample was grouped according to the aortic valve prosthesis size: ?21 mm (small) and >21 mm (standard). The effect of variables on outcomes was determined by univariate and multivariable regression analyses.</p><p><b>Results:</b> PPM was found significantly more among patients with AVR ? 21mm (<i>P</i> < 0.0001). Moreover, the likelihood of mortality also was significantly higher in these patients (<i>P</i> < 0.0001). Univariate analysis demonstrated small prosthesis size, urgent operation, PPM, female gender, and NYHA Class IV as significant predictors of mortality. Multivariate regression identified female gender, PPM, and urgent operation as the key independent predictors of mortality.</p><p><b>Conclusion:</b> PPM and female gender are significant predictors of mortality. Care should be taken to prevent PPM by implanting larger prosthesis especially in females.</p>

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