Gender differences in the pathophysiology, clinical presentation, and outcomes of ischemic heart failure

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

Despite advances in the treatment of acute myocardial infarction (MI), heart failure (HF) remains a frequent acute and long-term outcome of ischemic heart disease (IHD). In response to acute coronary ischemia, women are relatively protected from apoptosis, and experience less adverse cardiac remodeling than men, frequently resulting in preservation of left ventricular size and ejection fraction. Despite these advantages, women are at increased risk for HF- complicating acute MI when compared with men. However, women with HF retain a survival advantage over men with HF, including a decreased risk of sudden death. Sexspecific treatment of HF has been hindered by historical under-representation of women in clinical trials, though recent work has suggested that women may have a differential response to some therapies such as cardiac resynchronization. This review highlights the sex differences in the pathophysiology, clinical presentation and outcomes of ischemic heart failure and discusses key areas worthy of further investigation.

Original languageEnglish (US)
Pages (from-to)267-276
Number of pages10
JournalCurrent Heart Failure Reports
Volume9
Issue number4
DOIs
StatePublished - Dec 2012

Fingerprint

Heart Failure
Myocardial Infarction
Cardiac Resynchronization Therapy
Sudden Death
Treatment Failure
Sex Characteristics
Stroke Volume
Myocardial Ischemia
Ischemia
Clinical Trials
Apoptosis
Survival
Therapeutics

Keywords

  • Coronary disease
  • Disparities
  • Gender
  • Heart failure
  • Ischemic heart disease
  • Myocardial infarction
  • Women

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)
  • Emergency Medicine

Cite this

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abstract = "Despite advances in the treatment of acute myocardial infarction (MI), heart failure (HF) remains a frequent acute and long-term outcome of ischemic heart disease (IHD). In response to acute coronary ischemia, women are relatively protected from apoptosis, and experience less adverse cardiac remodeling than men, frequently resulting in preservation of left ventricular size and ejection fraction. Despite these advantages, women are at increased risk for HF- complicating acute MI when compared with men. However, women with HF retain a survival advantage over men with HF, including a decreased risk of sudden death. Sexspecific treatment of HF has been hindered by historical under-representation of women in clinical trials, though recent work has suggested that women may have a differential response to some therapies such as cardiac resynchronization. This review highlights the sex differences in the pathophysiology, clinical presentation and outcomes of ischemic heart failure and discusses key areas worthy of further investigation.",
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