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Sex and Heart Failure with Preserved Ejection Fraction: From Pathophysiology to Clinical Studies

Heart failure with preserved ejection fraction (HFpEF) represents the most frequent form of heart failure in women, with almost two-fold higher prevalence than in men. Studies have revealed sex-specific HFpEF pathophysiology, and suggested the possibility of a sex-specific therapeutic approach in th...

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Autores principales: Tadic, Marijana, Cuspidi, Cesare, Plein, Sven, Belyavskiy, Evgeny, Heinzel, Frank, Galderisi, Maurizio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6617502/
https://www.ncbi.nlm.nih.gov/pubmed/31167429
http://dx.doi.org/10.3390/jcm8060792
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author Tadic, Marijana
Cuspidi, Cesare
Plein, Sven
Belyavskiy, Evgeny
Heinzel, Frank
Galderisi, Maurizio
author_facet Tadic, Marijana
Cuspidi, Cesare
Plein, Sven
Belyavskiy, Evgeny
Heinzel, Frank
Galderisi, Maurizio
author_sort Tadic, Marijana
collection PubMed
description Heart failure with preserved ejection fraction (HFpEF) represents the most frequent form of heart failure in women, with almost two-fold higher prevalence than in men. Studies have revealed sex-specific HFpEF pathophysiology, and suggested the possibility of a sex-specific therapeutic approach in these patients. Some cardiovascular risk factors, such as arterial hypertension, obesity, diabetes mellitus, coronary artery disease, atrial fibrillation, and race, show specific features that might be responsible for the development of HFpEF in women. These risk factors are related to specific cardiovascular changes—left ventricular diastolic dysfunction and hypertrophy, ventricular–vascular coupling, and impaired functional capacity—that are related to specific cardiac phenotype and HFpEF development. However, there is no agreement regarding outcomes in women with HFpEF. For HFpEF, most studies have found higher hospitalization rates for women than for men. Mortality rates are usually not different. Pharmacological treatment in HFpEF is challenging, along with many unresolved issues and questions raised. Available data on medical therapy in patients with HFpEF show no difference in outcomes between the sexes. Further investigations are necessary to better understand the pathophysiology and mechanisms of HFpEF, as well as to improve and eventually develop sex-specific therapy for HFpEF.
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spelling pubmed-66175022019-07-18 Sex and Heart Failure with Preserved Ejection Fraction: From Pathophysiology to Clinical Studies Tadic, Marijana Cuspidi, Cesare Plein, Sven Belyavskiy, Evgeny Heinzel, Frank Galderisi, Maurizio J Clin Med Review Heart failure with preserved ejection fraction (HFpEF) represents the most frequent form of heart failure in women, with almost two-fold higher prevalence than in men. Studies have revealed sex-specific HFpEF pathophysiology, and suggested the possibility of a sex-specific therapeutic approach in these patients. Some cardiovascular risk factors, such as arterial hypertension, obesity, diabetes mellitus, coronary artery disease, atrial fibrillation, and race, show specific features that might be responsible for the development of HFpEF in women. These risk factors are related to specific cardiovascular changes—left ventricular diastolic dysfunction and hypertrophy, ventricular–vascular coupling, and impaired functional capacity—that are related to specific cardiac phenotype and HFpEF development. However, there is no agreement regarding outcomes in women with HFpEF. For HFpEF, most studies have found higher hospitalization rates for women than for men. Mortality rates are usually not different. Pharmacological treatment in HFpEF is challenging, along with many unresolved issues and questions raised. Available data on medical therapy in patients with HFpEF show no difference in outcomes between the sexes. Further investigations are necessary to better understand the pathophysiology and mechanisms of HFpEF, as well as to improve and eventually develop sex-specific therapy for HFpEF. MDPI 2019-06-04 /pmc/articles/PMC6617502/ /pubmed/31167429 http://dx.doi.org/10.3390/jcm8060792 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Tadic, Marijana
Cuspidi, Cesare
Plein, Sven
Belyavskiy, Evgeny
Heinzel, Frank
Galderisi, Maurizio
Sex and Heart Failure with Preserved Ejection Fraction: From Pathophysiology to Clinical Studies
title Sex and Heart Failure with Preserved Ejection Fraction: From Pathophysiology to Clinical Studies
title_full Sex and Heart Failure with Preserved Ejection Fraction: From Pathophysiology to Clinical Studies
title_fullStr Sex and Heart Failure with Preserved Ejection Fraction: From Pathophysiology to Clinical Studies
title_full_unstemmed Sex and Heart Failure with Preserved Ejection Fraction: From Pathophysiology to Clinical Studies
title_short Sex and Heart Failure with Preserved Ejection Fraction: From Pathophysiology to Clinical Studies
title_sort sex and heart failure with preserved ejection fraction: from pathophysiology to clinical studies
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6617502/
https://www.ncbi.nlm.nih.gov/pubmed/31167429
http://dx.doi.org/10.3390/jcm8060792
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