心血管病理生理学的性别差异:为什么女性在心力衰竭中占有过多的比例
Anna L Beale1,2,3, Philippe Meyer3, Thomas H Marwick1,2
1Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia (A.L.B., T.H.M., D.M.K.).
Circulation
|July 11, 2018
概括
女性更容易患心力衰竭,因为她们的喷射分数保存 (HFpEF). 本综述探讨了女性心脏功能,血液循环和相关疾病的性别差异.
科学领域:
- 心脏病学
- 生殖健康
- 流行病学
背景情况:
- 流行病学研究始终显示女性心力衰竭的患病率与男性相比较高.
- 了解导致这种性别差异的生物学和临床因素对于提高HFpEF知识和治疗至关重要.
研究的目的:
- 审查性别对心脏结构和功能,心血管循环和心脏外因子的影响.
- 找出可能解释女性对HFpEF倾向的机制.
- 讨论HFpEF诊断和治疗的性别特异性考虑.
主要方法:
- 文献审查和现有流行病学和生理学数据的综合.
- 对心脏和血管领域的性别特异性影响的评估.
- 在HFpEF病原体中分析心脏外因子和并发症.
主要成果:
- 性别影响心脏结构,全身和肺循环以及与HFpEF相关的心脏外因素.
- 怀孕,妊娠前和缺铁等因素可能会导致女性的HFpEF风险.
- 关于HFpEF的性别差异仍然存在重大知识差距和争议.
结论:
- 性别是HFpEF病理生理学和临床表现的关键决定因素.
- 性别特异性因素需要进一步研究以阐明HFpEF机制.
- 根据性别定制诊断标准,风险分层和治疗策略,可以改善所有HFpEF患者的结果.
相关概念视频
Heart Failure II: Pathophysiology
975
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
975
Pathophysiology of Heart Failure
3.8K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
3.8K
Heart Failure I: Introduction
924
Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
924
Heart Failure VI: Adjunct Therapies
368
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
368
Heart Failure Drugs: Diuretics
990
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
990
Heart Failure V: Medical Management
342
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
342


