急性心力衰竭治疗的性别差异:治疗质量是否存在差距?

IF 3.8 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Current Heart Failure Reports Pub Date : 2023-04-01 DOI:10.1007/s11897-023-00593-2
Elena Collado-Lledó, Francisco de la Cuerda, Albert Ariza-Solé
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引用次数: 4

摘要

回顾的目的:男性和女性在心力衰竭的人口统计学和临床表型上的差异,以及在治疗和结果上的差异已经被描述过。本文综述了关于急性心力衰竭及其最严重形式——心源性休克的性别相关差异的最新证据。最近的发现:最近5年的数据再次证实了之前的观察结果,急性心力衰竭的女性年龄越大,射血分数越保留,急性失代偿的缺血性原因越少。尽管女性仍然接受较少侵入性的手术和较少优化的医疗,但最近的研究发现,无论性别,结果都是相似的。这些差异在心源性休克的情况下仍然存在,即使女性表现出更严重的形式,她们接受的机械循环支持装置也更少。这篇综述揭示了女性急性心力衰竭和心源性休克与男性不同的临床情况,这转化为管理上的差异。研究中需要更多的女性代表,以便更好地了解这些差异的生理病理基础,并尽量减少治疗和结果方面的不平等。
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Sex Differences in Acute Heart Failure Management: Is There a Gap in Treatment Quality?

Purpose of review: Differences between men and women in demographics and clinical phenotype of heart failure have previously been described, as well as disparities in management and outcomes. This review summarizes the latest evidence concerning sex-related differences in acute heart failure and its most severe form, cardiogenic shock.

Recent findings: Data from the last 5 years reaffirm the previous observations, with women with acute heart failure being older, more often having preserved ejection fraction and less frequently having an ischemic cause of the acute decompensation. Despite women still receive less invasive procedures and a less optimized medical treatment, the most recent studies find similar outcomes regardless of sex. These disparities persist in the context of cardiogenic shock, where women receive less mechanical circulatory support devices even if they present with more severe forms. This review reveals a different clinical picture of women with acute heart failure and cardiogenic shock compared to men, which translates into disparities in management. More female representation in studies would be needed in order to better understand the physiopathological basis of these differences and minimize inequalities in treatment and outcomes.

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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.
期刊最新文献
Cardiogenic Shock: Focus on Non-Cardiac Biomarkers. Biomarkers of Hemodynamic Congestion in Heart Failure. Heart Failure in Rheumatoid Arthritis: Clinical Implications. Screening for Heart Failure: Biomarkers to Detect Heightened Risk in the General Population. Troponin Elevation in Asymptomatic Cancer Patients: Unveiling Connections and Clinical Implications.
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