Sudden Death in Men Versus Women with Heart Failure.

IF 3.8 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Current Heart Failure Reports Pub Date : 2023-04-01 DOI:10.1007/s11897-023-00596-z
Jorge Martínez-Solano, Manuel Martínez-Sellés
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Abstract

Purpose of review: Sudden cardiac death (SCD) represents the most feared complication of heart failure (HF). This review intends to provide insight on our current knowledge of sex differences in SCD mechanisms, prevention, and management in HF patients.

Recent findings: Women with HF present a better prognosis than men and have a lower incidence of SCD, irrespective of the presence of ischemic heart disease and age. The influence of sex hormones, sex differences in intracellular calcium handling, and a differential myocardial remodeling may explain such a gap between men and women. Both HF drugs and ventricular arrhythmias ablation seems also useful for the management of women at risk of SCD, but special care must be taken with the use of antiarrhythmic QT-prolonging drugs. However, implantable cardioverter defibrillator (ICD) use has not been shown to be equally effective in women than men. Sex-specific recommendations regarding SCD in HF are still lacking due to the scarcity of information and the under-representation of women in clinical trials. Further investigation is required to provide specific risk stratification models in women. Cardiac magnetic resonance imaging, genetics development, and personalized medicine will probably play an increasing role in this evaluation.

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男性与女性心力衰竭患者的猝死
综述目的:心源性猝死(SCD)是心力衰竭(HF)最可怕的并发症。这篇综述旨在提供我们目前对心衰患者SCD机制、预防和管理的性别差异的了解。最近的研究发现:与缺血性心脏病的存在和年龄无关,HF的女性预后比男性好,SCD的发病率更低。性激素的影响、细胞内钙处理的性别差异以及不同的心肌重构可能解释了男性和女性之间的这种差距。HF药物和室性心律失常消融术似乎对有SCD风险的女性也有用,但使用抗心律失常qt延长药物时必须特别小心。然而,植入式心律转复除颤器(ICD)的使用并没有显示在女性和男性中同样有效。由于信息缺乏和临床试验中女性代表性不足,关于心衰SCD的性别特异性建议仍然缺乏。需要进一步调查以提供具体的妇女风险分层模型。心脏磁共振成像、遗传学发展和个性化医疗可能会在这一评估中发挥越来越大的作用。
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来源期刊
Current Heart Failure Reports
Current Heart Failure Reports Medicine-Emergency Medicine
CiteScore
5.30
自引率
0.00%
发文量
44
期刊介绍: This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of heart failure. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as investigative, pharmacologic, and nonpharmacologic therapies, pathophysiology, and prevention. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.
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