EFFECT OF AGE AND GENDER ON ARRHYTHMIAS IN PATIENTS WITH CHRONIC HEART FAILURE

  • Madiha Sarwar Department of Physiology, Foundation University Medical College
  • Syed Muhammad Imran Majeed Department of Clinical Cardiac Electrophysiology Armed Forces Institute of Cardiology/National Institute of Heart Diseases
  • Muhammad Alamgir Khan Department of Physiology, Army Medical College
  • Tausif Ahmed Department of Biochemistry, Margalla Institute of Health Sciences
  • Faizania Shabbir Department of Physiology, Rawalpindi Medical College, Rawalpindi, Pakistan
Keywords: Arrhythmias, heart rate variability, ambulatory ECG recording, holter monitor

Abstract

Background: Heart failure is a complex clinical syndrome. Modern therapeutics have led to an increase in prevalence and incidence of heart failure among the aging population. The prognosis of heart failure in women has generally been better than in men. The main cause of death in heart failure is supposed to be the sudden arrhythmic death. Arrhythmia frequency varies in both sexes. Different hormonal and electrophysiological differences exist between genders that contribute to arrhythmogenesis. Objective: To determine the effect of age and gender on arrhythmias in patients with chronic heart failure. Methods: This descriptive cross sectional study was conducted at Armed Forces Institute of Cardiology/National Institute of Heart Diseases, from April to August 2013. It involved 48-hour holter monitoring of 53 heart failure patients using holter electrocardiography recorder. Digital ECG data were analysed for type and frequency of arrhythmias. Effect of age and gender on arrhythmias was finally analysed using statistical software. Results: There was no significant association of advancing age with the rise in arrhythmia frequency. Effect of gender on arrhythmias analysis revealed that frequency of arrhythmias was significantly higher in females as compared to males (p-value < 0.05). Conclusion: Arrhythmia frequency was significantly low in men as compared to women, but the effect of age on arrhythmogenesis was not significant.

Pak J Physiol 2013;9(2):11–4

References

1. Griffin BP, Topol EJ. Cariovascular Medicine. Lippincott Williams & Wilkins; 2009.
2. McMurray JJ, Petrie MC, Murdoch DR, Davie AP. Clinical epidemiology of heart failure: public and private health burden. Eur Heart J 1998;19(Suppl P):P9–16.
3. Lloyd-Jones D, Adams RJ, Brown TM, Carnethon M, Dai S, De Simone G, et al. Heart disease and stroke statistics–2010 update: a report from the American Heart Association. Circulation 2010;121(7):e46–e215.
4. McMurray JJ, Adamopoulos S, Anker SD, Auricchio A, Bohm M, Dickstein K, et al. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. European J Heart Fail 2012;14(8):803–69.
5. Owan TE, Redfield MM. Epidemiology of diastolic heart failure. Prog Cardiovas Dis 2005;47(5):320–32.
6. Jessup M, Brozena S. Heart failure. N Engl J Med 2003;348(20):2007–18.
7. Lloyd-Jones DM, Larson MG, Leip EP, Beiser A, D’Agostino RB, Kannel WB, et al. Lifetime risk for developing congestive heart failure: the Framingham Heart Study. Circulation 2002;106(24):3068–72.
8. Ho KK, Anderson KM, Kannel WB, Grossman W, Levy D. Survival after the onset of congestive heart failure in Framingham Heart Study subjects. Circulation 1993;88(1):107–15.
9. Levy D, Kenchaiah S, Larson MG, Benjamin EJ, Kupka MJ, Ho KK, et al. Long-term trends in the incidence of and survival with heart failure. N Engl J Med 2002;347(18):1397–402.
10. Frazier CG, Alexander KP, Newby LK, Anderson S, Iverson E, Packer M, et al. Associations of gender and etiology with outcomes in heart failure with systolic dysfunction: a pooled analysis of 5 randomized control trials. J Am Coll Cardiol 2007;49(13):1450–8.
11. O’Meara E, Clayton T, McEntegart MB, McMurray JJ, Pina IL, Granger CB, et al. Sex differences in clinical characteristics and prognosis in a broad spectrum of patients with heart failure: results of the Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity (CHARM) program. Circulation 2007;115(24):3111–20.
12. Roger VL, Weston SA, Redfield MM, Hellermann-Homan JP, Killian J, Yawn BP, et al. Trends in heart failure incidence and survival in a community-based population. JAMA 2004;292(3):344–50.
13. Curtis LH, Greiner MA, Hammill BG, Kramer JM, Whellan DJ, Schulman KA, et al. Early and long-term outcomes of heart failure in elderly persons, 2001–2005. Arch Intern Med 2008;168(22):2481–8.
14. Narang R, Cleland JG, Erhardt L, Ball SG, Coats AJ, Cowley AJ, et al. Mode of death in chronic heart failure. A request and proposition for more accurate classification. Eur Heart J 1996;17(9):1390–403.
15. Mosterd A, Cost B, Hoes AW, de Bruijne MC, Deckers JW, Hofman A, et al. The prognosis of heart failure in the general population: The Rotterdam Study. Eur Heart J 2001;22(15):1318–27.
16. Cleland JG, Erhardt L, Murray G, Hall AS, Ball SG. Effect of ramipril on morbidity and mode of death among survivors of acute myocardial infarction with clinical evidence of heart failure. A report from the AIRE Study Investigators. Eur Heart J 1997;18(1):41–51.
17. Greenberg H, Case RB, Moss AJ, Brown MW, Carroll ER, Andrews ML. Analysis of mortality events in the Multicenter Automatic Defibrillator Implantation Trial (MADIT-II). J Am Coll Cardiol 2004;43(8):1459–65.
18. Mosterd A HA. Clinical epidemiology of heart failure. Heart 2007;93:1137–46.
19. Rosano GM, Leonardo F, Dicandia C, Sheiban I, Pagnotta P, Pappone C, et al. Acute electrophysiologic effect of estradiol 17beta in menopausal women. Am J Cardiol 2000;86(12):1385–7, A5–6.
20. Carnes CA, Dech SJ. Effects of dihydrotestosterone on cardiac inward rectifier K+ current. Int J Androl 2002;25(4):210–4.
21. Lu HR, Marien R, Saels A, De Clerck F. Are there sex-specific differences in ventricular repolarization or in drug-induced early after depolarizations in isolated rabbit Purkinje fibers? J Cardiovasc Pharmacol 2000;36(1):132–9.
22. Bidoggia H, Maciel JP, Capalozza N, Mosca S, Blaksley EJ, Valverde E, et al. Sex differences on the electrocardiographic pattern of cardiac repolarization: possible role of testosterone. Am Heart J 2000;140(4):678–83.
23. Bongiorni MG, Paperini L, Viani S, Di Cori A, Zucchelli G, Soldati E. [Does a woman’s heart beat faster?]. G Ital Cardiol (Rome) 2012;13(6):440–7. [Article in Italian]
24. Ghali JK, Krause-Steinrauf HJ, Adams KF, Khan SS, Rosenberg YD, Yancy CW, et al. Gender differences in advanced heart failure: insights from the BEST study. J Am Coll Cardiol 2003;42(12):2128–34.
25. Lampert R, McPherson CA, Clancy JF, Caulin-Glaser TL, Rosenfeld LE, Batsford WP. Gender differences in ventricular arrhythmia recurrence in patients with coronary artery disease and implantable cardioverter-defibrillators. J Am Coll Cardiol 2004;43(12):2293–9.
26. Kurokawa J, Kodama M, Furukawa T, Clancy CE. Sex and gender aspects in antiarrhythmic therapy. Handbook of Experimental Pharmacology 2012(214):237–63.
27. Wolbrette D, Naccarelli G, Curtis A, Lehmann M, Kadish A. Gender differences in arrhythmias. Clin Cardiol 2002;25(2):49–56.
28. Djousse L, Driver JA, Gaziano JM. Relation between modifiable lifestyle factors and lifetime risk of heart failure. JAMA 2009;302(4):394–400.
29. Jong P, Vowinckel E, Liu PP, Gong Y, Tu JV. Prognosis and determinants of survival in patients newly hospitalized for heart failure: a population-based study. Arch Intern Med 2002;162(15):1689–94.
30. White HD, Aylward PE, Huang Z, Dalby AJ, Weaver WD, Barvik S, et al. Mortality and morbidity remain high despite Captopril and/or Valsartan therapy in elderly patients with left ventricular systolic dysfunction, heart failure, or both after acute myocardial infarction: results from the Valsartan in Acute Myocardial Infarction Trial (VALIANT). Circulation 2005;112(22):3391–9.
31. Francis GS. Development of arrhythmias in the patient with congestive heart failure: pathophysiology, prevalence and prognosis. Am J Cardiol 1986;57(3):3B–7B.
32. Curtis LH, Whellan DJ, Hammill BG, Hernandez AF, Anstrom KJ, Shea AM, et al. Incidence and prevalence of heart failure in elderly persons, 1994–2003. Arch Intern Med 2008;168(4):418–24.
33. Rodriguez F, Wang Y, Johnson CE, Foody JM. National patterns of heart failure hospitalizations and mortality by sex and age. J Card Fail 2013;19(8):542–9.

Downloads

Download data is not yet available.
Published
2013-12-31
How to Cite
1.
Sarwar M, Imran Majeed S, Khan M, Ahmed T, Shabbir F. EFFECT OF AGE AND GENDER ON ARRHYTHMIAS IN PATIENTS WITH CHRONIC HEART FAILURE. PJP [Internet]. 31Dec.2013 [cited 21Feb.2020];9(2):11-4. Available from: http://pjp.pps.org.pk/index.php/PJP/article/view/366