大动脉狭窄:基于性别的方法的时候了吗?
Aurelia Zimmerli1, Quentin Liabot1, Georgios Tzimas1
1Service of Cardiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland.
Journal of clinical medicine
|April 26, 2025
概括
大动脉狭窄 (AS) 对男性和女性的影响不同,女性往往晚些时候被诊断出并未得到充分治疗. 认识到性别差异对于及时干预和改善大动脉狭窄管理结果至关重要.
科学领域:
- 心脏病学 心脏病学
- 膜心脏疾病 膜心脏疾病
- 医学中的性别差异.
背景情况:
- 大动脉狭窄 (AS) 患病率随着年龄的增长而增加,历史上被认为在男性中更为常见.
- 最近的数据显示,男性和女性的患病率相似,老年女性的患病率较高,原因在于长寿.
- 在AS临床表现,解剖学,病理生理学和疾病进展方面存在与性别相关的差异.
研究的目的:
- 突出一大动脉狭窄 (AS) 的性别特异性差异.
- 为了强调女性AS诊断和治疗的挑战.
- 强调需要量身定制的管理策略和干预措施.
主要方法:
- 关于大动脉狭窄的性别差异的当前文献的综述.
- 对临床表现,解剖学变异和病理生理学影响的分析.
- 对诊断挑战和治疗差异的评估,包括跨导管大动脉植入 (TAVI).
主要成果:
- 患有AS的女性通常会出现更严重的症状,如呼吸障碍和功能障碍,而男性则报告胸痛.
- 女性的解剖学变化 (较小的身体表面积, annuli 和大动脉根) 影响流动动力学和严重程度分级.
- 妇女经历诊断延迟和治疗不足,尽管严重的AS,但接受的干预较少.
结论:
- 在AS中性别特异性差异需要量身定制的诊断和治疗值.
- 过导管大动脉植入 (TAVI) 对女性来说是有前途的,但需要适应的手术技术.
- 个性化管理策略,包括性别特定数据和人工智能,对于优化大动脉狭窄的结果至关重要.
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