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The Role of Vascular Imaging in Guiding Routine Percutaneous Coronary Interventions: A Meta-Analysis of Bare Metal Stent and Drug-Eluting Stent Trials Coronary calcification in the diagnosis of coronary artery disease Sex- and Race-Related Differences in Characteristics and Outcomes of Hospitalizations for Heart Failure With Preserved Ejection Fraction From Focal Lipid Storage to Systemic Inflammation Angiotensin–Neprilysin Inhibition in Heart Failure with Preserved Ejection Fraction Primary Prevention of Sudden Cardiac Death Is Cardiac Diastolic Dysfunction a Part of Post-Menopausal Syndrome? Association of Cardiovascular Disease With Respiratory Disease The Prevalence of Myocardial Bridging Associated with Coronary Endothelial Dysfunction in Patients with Chest Pain and Non-Obstructive Coronary Artery Disease Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction
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Review Article2018 Jul 10;138(2):198-205.

JOURNAL：Circulation. Article Link

Sex Differences in Cardiovascular Pathophysiology: Why Women Are Overrepresented in Heart Failure With Preserved Ejection Fraction

Beale AL, Meyer P, Kaye DM et al. Keywords: heart failure; myocardium; sex factors; vascular stiffness; women

ABSTRACT

Consistent epidemiological data demonstrate that patients with heart failure with preserved ejection fraction (HFpEF) are more likely to be women than men. Exploring mechanisms behind this sex difference in heart failure epidemiology may enrich the understanding of underlying HFpEF pathophysiology and phenotypes, with the ultimate goal of identifying therapeutic approaches for the broader HFpEF population. In this review we evaluate the influence of sex on the key domains of cardiac structure and function, the systemic and pulmonary circulation, as well as extracardiac factors and comorbidities that may explain the predisposition of women to HFpEF. We highlight the potential role of factors exclusive to or more prevalent in women such as pregnancy, preeclampsia, and iron deficiency. Finally, we discuss existing controversies and gaps in knowledge, as well as the clinical importance of known sex differences in the context of the potential need for sex-specific diagnostic criteria, improved risk stratification models, and targeted therapies.

© 2018 American Heart Association, Inc.

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