Sex differences in heart failure with preserved ejection fraction: From traditional risk factors to sex-specific risk factors.
Sex differences in heart failure with preserved ejection fraction: From traditional risk factors to sex-specific risk factors.
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DOI：
10.1177/17455057221140209
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发表时间：
2022-01
期刊：
影响因子：
2.4
通讯作者：
Lau, Emily
中科院分区：
文献类型：
--
作者：
Kaur, Gurleen;Lau, Emily
射血分数保留的心力衰竭在女性中的患病率高于男性。有几种已提出的机制可以解释这种性别差异，包括心血管对共病适应的差异和潜在的潜在病因机制。在这篇综述中，我们总结了传统危险因素中的性别差异，如肥胖、糖尿病、高血压和冠状动脉疾病，这些因素导致女性心力衰竭的发展并保留射血分数。此外，我们还探讨了女性特有的危险因素，如性激素、不良妊娠结局和其他生殖因素，这可能解释了心力衰竭在女性中占主导地位的原因。除了风险因素的性别差异外，结果也存在显著的性别差异，女性报告的生活质量低于男性，但总体生存状况好于男性。最后，尽管射血分数保留的心力衰竭患者的治疗选择仍然有限，但现有治疗方法的性别差异也已被报道，这表明女性使用保存射血分数治疗的特定心力衰竭优先受益。需要进一步的工作来更好地了解射血分数保持不变的心力衰竭的性别差异，包括更深入地了解病理生理机制，推导更准确的风险分层模型，以及增加临床试验中女性的代表性。
Heart failure with preserved ejection fraction has a higher prevalence in women versus men. There are several proposed mechanisms to explain this sex discrepancy including differences in cardiovascular adaptation to comorbidities and potential underlying etiologic mechanisms. In this review, we summarize sex differences in traditional risk factors, such as obesity, diabetes, hypertension, and coronary artery disease, which contribute to the development of heart failure with preserved ejection fraction in women. Furthermore, we explore female-specific risk factors, such as sex hormones, adverse pregnancy outcomes, and other reproductive factors, which may explain the predominance of heart failure with preserved ejection fraction in women. Beyond sex differences in risk factors, there are also significant sex differences in outcomes with women reporting lower quality of life but overall better survival versus men. Finally, while treatment options for patients with heart failure with preserved ejection fraction are still limited, sex differences have also been reported for the available therapies, with suggestion of preferential benefit of specific heart failure with preserved ejection fraction therapies in women. Further work is required to better understand sex differences in heart failure with preserved ejection fraction, including deeper understanding of pathophysiological mechanisms, derivation of more accurate risk stratification models, and increased representation of women in clinical trials.
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影响因子：
13.8
作者：
Hansen AL;Søndergaard MM;Hlatky MA;Vittinghof E;Nah G;Stefanick ML;Manson JE;Farland LV;Wells GL;Mongraw-Chaffin M;Gunderson EP;Van Horn L;Wild RA;Liu B;Shadyab AH;Allison MA;Liu S;Eaton CB;Honigberg MC;Parikh NI
通讯作者：
Parikh NI
影响因子：
3.5
作者：
Faxen, Ulrika Ljung;Hage, Camilla;Lund, Lars H.
通讯作者：
Lund, Lars H.
DOI：
10.1161/hhf.0b013e318291329a
发表时间：
2013-05
期刊：
Circulation. Heart failure
影响因子：
--
作者：
Heidenreich PA;Albert NM;Allen LA;Bluemke DA;Butler J;Fonarow GC;Ikonomidis JS;Khavjou O;Konstam MA;Maddox TM;Nichol G;Pham M;Piña IL;Trogdon JG;American Heart Association Advocacy Coordinating Committee;Council on Arteriosclerosis, Thrombosis and Vascular Biology;Council on Cardiovascular Radiology and Intervention;Council on Clinical Cardiology;Council on Epidemiology and Prevention;Stroke Council
通讯作者：
Stroke Council
影响因子：
7.1
作者：
Breetveld, N. M.;Ghossein-Doha, C.;Spaanderman, M. E. A.
通讯作者：
Spaanderman, M. E. A.
影响因子：
39.3
作者：
GARAVAGLIA, GE;MESSERLI, FH;OREN, S
通讯作者：
OREN, S