Background:Although women with heart failure (HF) are potentially more likely to be physically frail compared with men with HF, the underlying contributors to this sex difference are poorly understood. The purpose of this study was to characterize sex differences in physical frailty phenotypes in HF.Methods:We prospectively enrolled adults with class I–IV HF. Physical frailty was measured with the frailty phenotype criteria. Symptoms of dyspnea, sleep-related impairment, pain interference, depression, and anxiety were assessed. Body composition was measured using dual-energy x-ray absorptiometry. Simple comparative statistics and stepwise regression modeling were used.Results:The average age of the sample (n=115) was 63.6±15.7 years, 49% were women, and 73% had nonischemic cause. Forty-three percent of the sample was physically frail. Women had a 4.6 times greater odds of being physically frail compared with men, adjusting for covariates (odds ratio=4.63 [95% CI, 1.81–11.84], P=0.001). Both physically frail men and women were characterized by more type 2 diabetes, higher comorbidity burden, and worse dyspnea symptoms. Physically frail women had significantly worse symptoms compared with non–physically frail women but no difference in body composition characteristics. Physically frail men had significantly lower appendicular muscle mass, higher percent fat, lower hemoglobin, and more depressive symptoms compared with non–physically frail men.Conclusions:Women are significantly more likely to be physically frail compared with men in HF. Physical frailty in both women and men is characterized by comorbidities and worse symptoms; physical frailty in men is characterized by worse physiological characteristics.

中文翻译：

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表征心力衰竭中身体虚弱表型的性别差异

背景：尽管与心力衰竭男性相比，心力衰竭 (HF) 女性更可能身体虚弱，但人们对这种性别差异的潜在原因知之甚少。本研究的目的是描述 HF 身体虚弱表型的性别差异。方法：我们前瞻性地招募了 I-IV 级 HF 成人。身体虚弱是用虚弱表型标准测量的。评估了呼吸困难、睡眠相关障碍、疼痛干扰、抑郁和焦虑的症状。使用双能 X 射线吸收仪测量身体成分。使用简单的比较统计和逐步回归模型。结果：样本的平均年龄（n=115）为63.6±15.7岁，49%为女性，73%为非缺血性原因。百分之四十三的样本身体虚弱。P = 0.001)。身体虚弱的男性和女性都具有更多的 2 型糖尿病、更高的合并症负担和更严重的呼吸困难症状。与非身体虚弱的女性相比，身体虚弱的女性症状明显更差，但身体成分特征没有差异。与非身体虚弱的男性相比，身体虚弱的男性的附肢肌肉质量显着降低，脂肪百分比更高，血红蛋白更低，抑郁症状更严重。结论：与患有 HF 的男性相比，女性身体虚弱的可能性显着增加。女性和男性身体虚弱的特点是合并症和更严重的症状；男性身体虚弱的特点是生理特征更差。