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Special Considerations in the Care of Women With Advanced Heart Failure

Imo A Ebong1, Ersilia M DeFilippis2, Eman A Hamad3

  • 1Division of Cardiovascular Medicine, University of California, Davis, Sacramento, CA, United States.

Frontiers in Cardiovascular Medicine
|July 28, 2022
PubMed

Insights

Women face higher risks and inequities in advanced heart failure (AHF) care. This review explores sex hormones, clinical aspects, and therapies for AHF in women, highlighting pregnancy, lactation, and menopause considerations.

Area of Science:

  • Cardiology
  • Reproductive Endocrinology
  • Health Inequities

Background:

  • Advanced heart failure (AHF) presents significant morbidity, mortality, and healthcare burdens.
  • Current AHF therapy allocation shows persistent inequities, particularly affecting women.
  • Women experience higher AHF-related mortality and are less referred for advanced therapies like heart transplantation or ventricular assist devices.

Purpose of the Study:

  • To review the influence of sex hormones on AHF pathophysiology.
  • To describe the clinical presentation, diagnosis, and treatment of AHF in women.
  • To address specific considerations for women including pregnancy, lactation, contraception, and menopause.

Main Methods:

  • Literature review focusing on sex-specific factors in AHF.
  • Analysis of clinical presentation and diagnostic criteria for AHF in women.
  • Examination of advanced therapy referral patterns and outcomes for women.

Main Results:

  • Sex-specific risk factors significantly impact AHF progression in women.
  • Hormonal influences on AHF pathophysiology require further investigation.
  • Disparities exist in access to advanced AHF therapies for women.

Conclusions:

  • Understanding sex hormones is crucial for managing AHF in women.
  • Addressing inequities in AHF care is essential for improving outcomes.
  • Further research is needed to optimize AHF management strategies for women across their lifespan.

Keywords:
advanced heart failureadvanced therapies (ATs)heart transplantventricular assist devicewomen

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