Introduction: Clinical course and patients’ (P) prognosis with ischaemic disease and heart failure varies between genders.
The aim of this study: evaluation if gender affects clinical course of adults with congenital heart defects (CHD) in long-term observation.
Material and method: from 1995 to 2006 (mean 5,53±2,5 years) we followed-up 1653 P (860 female) aged 18-74 years (33,4±10,2). Following clinical events were analysed: supraventricular arrhythmia (SVA): paroxysmal supraventricular tachycardia or/and atrial fibrillation/flutter, ventricular arrhythmia (VA): ≥ 30/h, conduction and rhythm disturbances (CRD): block AVI-III, nodal rhythm, HR<40/min, pauses≥2ms, NYHA≥III, death.
P represented 21 different CHD – simple: ASD, VSD, PDA, BAV, pulmonary stenosis, pulmonary venous connection anomaly, mitral insufficiency, Wiliams, Marfan, Ebstein, Eisenmenger syndromes, and complex: coarctation of aorta, Fallot tetralogy, ASDI, CAVC, , subvalvularAS, univentricular heart, CCTGA, DTGA, DORV, pulmonary atresia. Kaplan-Meier curves were estimated, log-rank tests were calculated to compare curves for genders.
Results: SVA occurred among 10,7% P, after five years –14,5% P. VA appeared in 6,3% P, after five years –11,2%P. CRD occurred among 10,8%P, after five years – 11,2%. NYHA≥III was observed among 2,6% P, after five years – 3,7% P, death among 2,3%P. Survival rate after five years- 96,8%. Incidence of VA, SVA, NYHA≥III, death did not differ between genders - (p=0,54), (p=0,32), (p=0,13), (p=0,45) respectively. Higher probability of CRD was observed among men (p=0,005), especially with complex defects (p=0,0002).
Conclusions: 1/ Probability of conduction and rhythm disturbances is higher among men. 2/ Incidence of SVA, VA, NYHA≥III, death does not differ between genders.