Sex Differences and Similarities in Valvular Heart Disease.
Sex Differences and Similarities in Valvular Heart Disease.
复制标题
心脏瓣膜病的性别差异和相似性。
DOI：
10.1161/circresaha.121.319914
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发表时间：
2022-02-18
影响因子：
20.1
通讯作者：
Delling FN
中科院分区：
文献类型：
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作者：
DesJardin JT;Chikwe J;Hahn RT;Hung JW;Delling FN
随着全球人口老龄化，心脏瓣膜病的负担呈指数级增长，受影响的妇女比例也呈指数级增长。虽然风湿性瓣膜病在高收入国家正在下降，但与年龄相关的退行性病因正在上升。钙化性主动脉瓣狭窄和退行性二尖瓣返流影响很大比例的老年女性，特别是合并症的老年女性。在许多里程碑式的研究中，患有心脏瓣膜病的女性代表性不足，这些研究构成了指南建议的基础。因此，妇女的手术转诊往往被推迟，与男子相比，术后结果更差。正如本综述所述，最近将女性纳入研究和临床试验的努力增加了我们对流行病学、病理生理学、诊断标准、治疗方案、结局和预后方面性别差异的了解。
As populations age worldwide, the burden of valvular heart disease has grown exponentially, and so has the proportion of affected women. Although rheumatic valve disease is declining in high-income countries, degenerative age-related etiologies are rising. Calcific aortic stenosis and degenerative mitral regurgitation affect a significant proportion of elderly women, particularly those with comorbidities. Women with valvular heart disease have been underrepresented in many of the landmark studies which form the basis for guideline recommendations. As a consequence, surgical referrals in women have often been delayed, with worse post-operative outcomes compared to men. As described in this review, a more recent effort to include women in research studies and clinical trials has increased our knowledge about sex-based differences in epidemiology, pathophysiology, diagnostic criteria, treatment options, outcomes, and prognosis.