性对心力衰竭死亡率的影响
Davide Colombo1, Valentina Mercurio2, Catherine Klersy3
1Division of Cardiology - Fondazione IRCCS Policlinico S Matteo, Pavia.
Journal of cardiovascular medicine (Hagerstown, Md.)
|July 31, 2024
概括
患有缺血性心脏病的女性心力衰竭患者的存活率更高,特别是老年人,排泄率降低的人,以及没有糖尿病或右室功能障碍的人.
科学领域:
- 心脏病学 心脏病学
- 医学中的性别差异
- 心力衰竭研究研究
背景情况:
- 慢性心力衰竭 (HF) 影响全球数以百万计的人,对性别特异性预后因素的理解有限.
- 在HF预后中调查性别差异对于个性化治疗策略至关重要.
研究的目的:
- 探索慢性心力衰竭 (HF) 患者预后的性别特异性差异.
- 分析这些差异的不同程度的左心室功能障碍 (HFrEF,HFmrEF,HFpEF),右心室 (RV) 功能障碍,以及病因 (缺血性心脏病[IHD]与非IHD).
主要方法:
- 对1640名高压患者的回顾性分析.
- 基于左心室功能障碍 (HFrEF,HFmrEF,HFpEF),RV功能障碍以及IHD或非IHD病因的分类.
- 随访时间中位数为63个月.
主要成果:
- 在非IHD患者中,没有观察到生存的显著性别差异.
- 在65-79岁的IHD患者中,女性的发病率明显低于男性 (HR 0.39).
- 女性在HFrEF (HR 0.47),没有VR功能障碍 (HR 0.58) 和没有糖尿病 (HR 0.44) 的事件率也较低.
结论:
- 非缺血性心力衰竭的生存率显示没有基于性别的差异.
- 在缺血性心力衰竭中,女性表现出更好的生存率,特别是在老年人中,那些有HFrEF的人,没有VR功能障碍,没有糖尿病.
相关概念视频
01:17Pathophysiology of Heart Failure
1.5K
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...
1.5K
01:22Heart Failure Drugs: β-Blockers
332
β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
332
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
413
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
413
01:26Imbalances in Cardiac Output
1.4K
The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
1.4K
01:29Pathophysiology of Cardiac Performance
624
Typical heart performance is influenced by heart rate, rhythm, myocardial contraction, and metabolism or blood flow. The cardiac muscle exhibits distinct electrophysiological features, including pacemaker activity and calcium channel control, which play a vital role in the heart's response to various drugs. The autonomic nervous system, comprising the sympathetic and parasympathetic branches, regulates heart rate. Sympathetic activation increases heart rate, while parasympathetic activation...
624
01:20Exercise and Cardiovascular Response
765
Exercise significantly impacts cardiovascular response, which is crucial for understanding patient health and designing effective treatment plans.
Light to moderate physical activity initiates a series of interconnected responses in the body. The heart rate modestly increases in anticipation of the workout, followed by widespread vasodilation as oxygen consumption by skeletal muscles increases. This results in decreased peripheral resistance, increased capillary blood flow, and accelerated...
Light to moderate physical activity initiates a series of interconnected responses in the body. The heart rate modestly increases in anticipation of the workout, followed by widespread vasodilation as oxygen consumption by skeletal muscles increases. This results in decreased peripheral resistance, increased capillary blood flow, and accelerated...
765