高度な心不全の治療における性差
1Heart and Vascular Institute at the Cleveland Clinic, OH. Cleveland Clinic Lerner College of Medicine of Case Western Reserve University School of Medicine, OH.
Circulation
|February 20, 2019
まとめ
デフィブリレーターやペースメーカーなどの 発達した心不全治療には 性別の違いがあります これらの格差を理解することは 心不全の女性と男性の両方に 治療の最適化と 結果の改善に不可欠です
科学分野:
- 心臓病科
- 医療機器
- 移植
背景:
- 高度な心不全 (AHF) の治療には複雑な治療法が必要です.
- 心血管疾患の流行と結果における 性差はますます認識されています
研究 の 目的:
- AHFの治療における性差に関する現在の文献をレビューし,統合する.
- 利用,有効性,有害事象,論争の差異を強調する.
主な方法:
- 埋め込み式心動脈除細動器 (ICD),双心室ペースメーカー (BVP),機械循環支援器 (MCS),心臓移植器 (HTx) に関する研究に関する包括的な文献レビュー.
- デバイスの埋め込み,臨床的有効性,患者のアウトカムに関する性別のデータに焦点を当てた分析.
主要な成果:
- 女性におけるICDの有効性については論争があるが,インプラント化が推奨されている.
- BVPの反応,心不全の入院,および死亡率で観察された性別の違い.
- HTx待ちリストの生存率とMCS装置の利用の格差が認められ,女性はLVADを投与する可能性が低い.
- LVADの生存率は同様だが,男女間の有害事象のプロファイルは異なっている.
- 女性のドナーハートと 男性のドナーハートとの結果に関する懸念は 性別ではなく サイズに関係しているかもしれません
結論:
- 性別による大きな差異は,先進的な心不全治療の有効性と利用に影響します.
- 治療のメカニズムを明らかにし,両方の性別で改善された結果のために治療を合わせるには,さらなる研究が不可欠です.
- AHFの治療を最適化するには,器具の選択と管理において性別特有の考慮が必要である.
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