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Congestive Heart Failure

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Association of the Hospital Readmissions Reduction Program With Mortality Among Medicare Beneficiaries Hospitalized for Heart Failure, Acute Myocardial Infarction, and Pneumonia Wireless pulmonary artery pressure monitoring guides management to reduce decompensation in heart failure with preserved ejection fraction 2019 ACC Expert Consensus Decision Pathway on Risk Assessment, Management, and Clinical Trajectory of Patients Hospitalized With Heart Failure: A Report of the American College of Cardiology Solution Set Oversight Committee Lifestyle Modifications for Preventing and Treating Heart Failure Impact of Myocardial Scar on Prognostic Implication of Secondary Mitral Regurgitation in Heart Failure Progression of Device-Detected Subclinical Atrial Fibrillation and the Risk of Heart Failure Phenotypic Refinement of Heart Failure in a National Biobank Facilitates Genetic Discovery Titration of Medical Therapy for Heart Failure With Reduced Ejection Fraction Association Between Functional Impairment and Medication Burden in Adults with Heart Failure H2FPEF Score for Predicting Future Heart Failure in Stable Outpatients With Cardiovascular Risk Factors

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.