Gender differences in the etiology of heart failure: A systematic review

Azad, Nahid; Kathiravelu, Anusha; Minoosepeher, Shabnam; Hébert, Paul; Fergusson, Dean

doi:10.3724/sp.j.1263.2011.00015

Cited by 53 publications

(13 citation statements)

References 39 publications

(40 reference statements)

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“…The present study also showed no significant association between female sex and LVSD. This finding may be related to the fact that in women, LVD tends to be related to hypertension and DM and associated with preserved EF, whereas in men, it is more likely to be provoked by myocardial infarction [ 21 ]. Our research also showed that age >65 years is a risk factor for developing AS and diastolic dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Mitral and Aortic Valvular Disease and Left Ventricular Dysfunction in a Lebanese Population: Retrospective Single-Center Experience

et al. 2020

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Background Recently, new therapeutic approaches have revolutionized the management of left ventricular dysfunction (LVD) and valvular heart disease (VHD), which are a growing public health problem. In parallel, there are no available epidemiological data about LVD and VHD in developing countries, especially in the Mediterranean area. This retrospective study was conducted at a single center and aimed to evaluate the associations between mitral and aortic valvular disease and left ventricle systolic and diastolic dysfunction in the Lebanese population. Material/Methods A retrospective study was conducted of 4520 consecutive patients aged >18 years who were referred to the Cardiovascular Department of Notre Dame de Secours-University Hospital in Jbeil-Lebanon for transthoracic echocardiography between December 2016 and December 2019. The study population was divided into different groups based on types of LVD and VHD. Left ventricle systolic dysfunction was defined as a left ventricle ejection fraction (EF) ≤40%. Statistical analysis was carried out using SPSS software version 20. Results VHD and systolic dysfunction were more common in men, whereas diastolic dysfunction was more common in women. Being older than age 65 years and smoking were significantly associated with heart failure with preserved EF, whereas female sex was a significant preventive factor against heart failure with reduced EF. Systemic hypertension was correlated with mitral stenosis and tricuspid regurgitation, whereas diabetes mellitus was associated with tricuspid regurgitation (TR). Smoking and older age also appeared to be associated with aortic stenosis. Conclusions Mitral valve disease (regurgitation and stenosis) was significantly correlated with systolic dysfunction, whereas aortic and mitral regurgitation were associated with diastolic dysfunction. Better monitoring of cardiovascular disease risk factors may lead to a reduced burden of LVD and VHD.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Mitral and Aortic Valvular Disease and Left Ventricular Dysfunction in a Lebanese Population: Retrospective Single-Center Experience

et al. 2020

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“…Females with heart failure have more frequently a preserved left ventricular ejection fraction than men [6, 16], and they also tend to be older. However, as the purpose of this study was to analyze the efficacy and safety of SV in HFrEF, patients with preserved or mid-range ejection fraction were not included.…”

Section: Discussionmentioning

confidence: 99%

Sex Influence on the Efficacy and Safety of Sacubitril/Valsartan

et al. 2019

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Background: Women are underrepresented in sacubitril/valsartan (SV) clinical trials. The aim of this study was to assess sex-specific differences in efficacy, tolerability, and safety of SV in real-world heart failure with reduced ejection fraction (HFrEF) patients. Methods: A prospective registry in 10 centers including all patients who started SV during the last 6 months was analyzed in this study. Results: A total of 427 patients were included, 126 (29.5%) were women. There were no substantial differences in HFrEF treatment before SV initiation, although fewer women than men carried an implantable cardioverter defibrillator (57 [45.2%] vs. 173 [58.1%], p = 0.02). SV starting dose was 24/26 mg b.i.d. in 206 patients (48.2%), 49/51 mg b.i.d. in 184 (43.1%), and 97/103 mg b.i.d. in 34 (8.2%), without relevant differences associated to sex. There were no losses during a mean follow-up of 7.0 ± 0.1 months. The proportion of patients who discontinued the drug (16 [12.7%] women vs. 33 [11.0%] men, p = 0.66) or presented SV-related adverse effects (31 [24.6%] women vs. 79 [26.5%] men, p = 0.72) was also similar in both sexes. However, female sex was an independent predictor of functional class improvement in the multivariate analysis (odds ratio 2.33, 95% confidence interval: 1.24–4.38, p = 0.04). Conclusions: SV in women with HFrEF has a similar tolerability as in men. Females seem to have a more frequent functional class improvement than males.

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“…The systolic HF occurs when the heart does not pump vigorously to push enough blood into the body due to abnormal contraction of the ventricle. The ventricular systolic dysfunction is more common in males, whereas females are more associated with preserved left ventricular function [4].…”

Section: Introductionmentioning

confidence: 99%

Gender based survival prediction models for heart failure patients: A case study in Pakistan

et al. 2019

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Objectives The objective of this study was to build and assess the performance of survival prediction models using the gender-specific informative risk factors for patients with left ventricular systolic dysfunction. Methods A lasso approach was used to decide the informative predictors for building semi-parametric proportional hazards Cox model. Separate models were built for all patients [N = 299], male patients [N male = 194 (64.88%)], and female patients [N female = 105 (35.12%)], to observe the risk factors associated with the individual’s risk of death. The likelihood- ratio test was used to test the goodness of fit of the selected model, and the C-index was used to assess the predictive performance of the selected model(s) with respect to the overall model with all observed risk factors. Results The survival prediction model for females is notably different from that for males. For males, smoking, diabetes, and anaemia, whereas for females, ejection fraction, sodium, and platelets count are non-informative with zero regression coefficients. The goodness of fit of the selected models with respect to the general model with all observed risk factors is tested using the likelihood-ratio test. The results are in favor of the selected models with p-values 0.51,0.61, and 0.70 for all patients, male patients, and female patients, respectively. The same values of C-index for the full model and the selected models for overall data, for males, and for females (0.72, 0.73, and 0.77 for overall data, male data, and female data, respectively) indicate that the selected models are as good as the corresponding overall models regarding their predictive performance. Conclusion There is a substantial difference in the survival prediction models for heart failure (HF) of male and female patients in this study. More studies are needed in Pakistan for confirming this striking male-female difference regarding the potential risk factors to predict survival with heart failure.

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Gender differences in the etiology of heart failure: A systematic review

Cited by 53 publications

References 39 publications

Evaluation of Mitral and Aortic Valvular Disease and Left Ventricular Dysfunction in a Lebanese Population: Retrospective Single-Center Experience

Evaluation of Mitral and Aortic Valvular Disease and Left Ventricular Dysfunction in a Lebanese Population: Retrospective Single-Center Experience

Sex Influence on the Efficacy and Safety of Sacubitril/Valsartan

Gender based survival prediction models for heart failure patients: A case study in Pakistan

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