Heart Failure Subtypes and Cardiomyopathies in Women.
Heart Failure Subtypes and Cardiomyopathies in Women.
复制标题
DOI：
10.1161/circresaha.121.319900
复制
发表时间：
2022-02-18
影响因子：
20.1
通讯作者：
Hsich, Eileen
中科院分区：
文献类型：
--
作者：
DeFilippis, Ersilia M.;Beale, Anna;Martin, Trejeeve;Agarwal, Anubha;Elkayam, Uri;Lam, Carolyn S. P.;Hsich, Eileen
心力衰竭影响美国超过260万女性和340万男性，在广泛的心肌病（包括围产期心肌病、肥厚型心肌病、应激性心肌病、心脏淀粉样变性和结节病）中，流行病学、管理、治疗反应和结局存在已知的性别差异。这些性别特异性因素中的一些是由性激素对肾素-血管紧张素-醛固酮系统、内皮对损伤的反应、血管老化和左心室重塑的细胞效应驱动的。其他的性别差异是由隐性偏见导致的，导致临床试验中的治疗不足和代表性不足。本叙述性综述的目的是全面检查过去十年中关于各种心力衰竭综合征从病理生理学观点到临床实践的性别差异的现有文献。
Heart failure affects over 2.6 million women and 3.4 million men in the United States with known sex differences in epidemiology, management, response to treatment and outcomes across a wide spectrum of cardiomyopathies that include peripartum cardiomyopathy, hypertrophic cardiomyopathy, stress cardiomyopathy, cardiac amyloidosis and sarcoidosis. Some of these sex-specific considerations are driven by the cellular effects of sex hormones on the renin-angiotensin-aldosterone system, endothelial response to injury, vascular aging, and left ventricular remodeling. Other sex differences are perpetuated by implicit bias leading to undertreatment and underrepresentation in clinical trials. The goal of this narrative review is to comprehensively examine the existing literature over the last decade regarding sex differences in various heart failure syndromes from pathophysiological insights to clinical practice.