Sex Differences in Pulmonary Hypertension

Rodríguez-Arias, Juan José; García‐Álvarez, Ana

doi:10.3389/fragi.2021.727558

Cited by 17 publications

(12 citation statements)

References 148 publications

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“…Although PAH can appear at any age, it is most prevalent in young adults. Sex differences are observed in clinical practice in most PAH cases [ 138 ]. The European COMPERA registry shows a higher prevalence in women compared to men, at a ratio of 2.3:1 for the age group up to 65 years old, compared to 1.2:1 in the case of patients over 65 years old [ 139 ].…”

Section: Age and Sex Differencesmentioning

confidence: 99%

“…Estrogens and androgens are pulmonary vasoactive components with variable effects on apoptosis and cell proliferation. It appears that sex hormones, especially estrogen, are the essential elements in understanding these mechanisms [ 138 ]. The literature describes an “estrogen paradox”.…”

Section: Age and Sex Differencesmentioning

confidence: 99%

“…This condition has an increased prevalence in the case of women, and estrogen has been associated with a higher risk of PAH development. However, paradoxically, once affected, women have a better prognosis, improved long-term survival, and increased favorable responses to treatment compared to men [ 1 , 138 , 142 ]. The results obtained on experimental models have been contradictory over time; nevertheless, the majority have demonstrated a protective effect of estrogen on pulmonary vascularization.…”

Section: Age and Sex Differencesmentioning

confidence: 99%

“…Dysregulation of estrogen synthesis and metabolism plays a major role in these sex-related differences [ 145 ]. Based on these data, there are some ongoing clinical trials to evaluate the effects of anti-estrogenic therapy in PAH (e.g., NCT03229499, NCT03528902), whose results are highly anticipated [ 138 ]. Indeed, further studies should be encouraged for a better understanding of the influence of sex on this disease, in order to establish new targeted treatments.…”

Section: Age and Sex Differencesmentioning

confidence: 99%

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Biomarkers in Pulmonary Arterial Hypertension

2022

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Pulmonary arterial hypertension (PAH) is a severe medical condition characterized by elevated pulmonary vascular resistance (PVR), right ventricular (RV) failure, and death in the absence of appropriate treatment. The progression and prognosis are strictly related to the etiology, biochemical parameters, and treatment response. The gold-standard test remains right-sided heart catheterization, but dynamic monitoring of systolic pressure in the pulmonary artery is performed using echocardiography. However, simple and easily accessible non-invasive assays are also required in order to monitor this pathology. In addition, research in this area is in continuous development. In recent years, more and more biomarkers have been studied and included in clinical guidelines. These biomarkers can be categorized based on their associations with inflammation, endothelial cell dysfunction, cardiac fibrosis, oxidative stress, and metabolic disorders. Moreover, biomarkers can be easily detected in blood and urine and correlated with disease severity, playing an important role in diagnosis, prognosis, and disease progression.

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Section: Age and Sex Differencesmentioning

confidence: 99%

Section: Age and Sex Differencesmentioning

confidence: 99%

Section: Age and Sex Differencesmentioning

confidence: 99%

Section: Age and Sex Differencesmentioning

confidence: 99%

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Biomarkers in Pulmonary Arterial Hypertension

2022

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“…Therefore, the researchers aimed to elucidate the relationships among QoL, FoP, and coping styles in individuals with PH using network analysis. Furthermore, given the differences in QoL, FoP, and coping styles by sex (Hasan et al, 2022;Pang & Humphris, 2021;Rodriguez-Arias & García-Álvarez, 2021) and age (Borgese et al, 2021;Olejniczak et al, 2022;Riggauer et al, 2022), the researchers also conducted a network comparison based on sex and age to ensure reliability of the results. S1 (Du & Fang, 2000).…”

Section: Introductionmentioning

confidence: 99%

Relationship between quality of life, fear of disease progression, and coping styles in patients with pulmonary hypertension: A network analysis

Wang,

Liu,

et al. 2023

Research in Nursing & Health

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A poor quality of life (QoL) in patients with pulmonary hypertension (PH) is often associated with emotional disturbances and the ability to cope. Little is known, however, about the intrinsic links among the QoL, fear of disease progression (FoP), and coping styles in patients with PH. The purpose of this study was to elucidate the relationships among QoL, FoP, and coping styles in patients with PH. We conducted a cross‐sectional survey of 247 patients from a tertiary hospital in Jinan, China and analyzed the relationships using network analysis. Participants completed the World Health Organization's Quality of Life Questionnaire, Fear of Disease Progression Questionnaire and Simple Coping Style Questionnaire during the survey period. The total QoL, positive coping, and negative coping scores were 46.55 ± 10.46, 31.75 ± 6.85, and 18.75 ± 4.66, respectively. The QoL psychological domain had the strongest centrality, deserving more attention than other domains. The coping styles were bridge nodes that connected the whole network, where negative coping and social family FoP, and positive coping and both social and psychological QoL had the strongest positive correlations. There were no significant sex‐based or age‐based differences in the networks. To improve QoL and psychological well‐being in people with PH, healthcare professionals must focus on issues beyond the patient's physical health. Specifically, they should focus on positive coping styles, while developing interventions to promote positive coping and reduce negative coping styles.

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Elevated systolic pulmonary artery pressure is a substantial predictor of increased mortality after transcatheter aortic valve replacement in males, not in females

Boxhammer,

Dienhart,

Kletzer

et al. 2023

Clin Res Cardiol

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Background While pulmonary hypertension (PH) in patients with severe aortic valve stenosis (AS) is associated with increased mortality after transcatheter aortic valve replacement (TAVR), there is limited data on gender differences in the effects on long-term survival. Objective The aim of this retrospective, multicenter study was to investigate the prognostic impact of pre-interventional PH on survival of TAVR patients with respect to gender. Methods 303 patients undergoing TAVR underwent echocardiography to detect PH prior to TAVR via measurement of systolic pulmonary artery pressure (sPAP). Different cut-off values were set for the presence of PH. The primary endpoint was all-cause mortality at 1, 3 and 5 years. Results Kaplan–Meier analysis by gender showed that only males exhibited significant increased mortality at elevated sPAP values during the entire follow-up period of 5 years (sPAP ≥ 40 mmHg: p ≤ 0.001 and sPAP ≥ 50 mmHg: p ≤ 0.001 in 1- to 5-year survival), whereas high sPAP values had no effect on survival in females. In Cox regression analysis based on the selected sPAP thresholds, male gender was an independent risk factor for long-term mortality after TAVR in all time courses. Conclusion Male gender was an isolated risk factor for premature death after TAVR in patients with echocardiographic evidence of PH and severe AS. This could mean that, the indication for TAVR should be discussed more critically in men with severe AS and an elevated sPAP, while in females, PH should not be an exclusion criterion for TAVR. Graphical abstract Graphical abstract of the study (Created with BioRender.com) Image material of CoreValve™ Evolut™ was kindly provided by © Medtronic Inc.

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Sex Differences in Pulmonary Hypertension

Cited by 17 publications

References 148 publications

Biomarkers in Pulmonary Arterial Hypertension

Biomarkers in Pulmonary Arterial Hypertension

Relationship between quality of life, fear of disease progression, and coping styles in patients with pulmonary hypertension: A network analysis

Elevated systolic pulmonary artery pressure is a substantial predictor of increased mortality after transcatheter aortic valve replacement in males, not in females

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