The Internal Medicine and Assessment of Gender Differences in Europe (IMAGINE): The new European Federation of Internal Medicine initiative on sex and gender medicine

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Heart Failure (HF) is a major healthcare issue, given its high prevalence and incidence, the rate of comorbidities, the related high health-care costs and its poor outcome. In the last years mounting evidence revealed several differences between men and women affected by this clinical condition. Apart from the well-known difference in phenotype (HF with reduced ejection fraction (HFrEF) occurs more commonly in men, and HF with preserved ejection fraction (HFpEF) is more frequent in women) other relevant sex-related issues dwell upon epidemiology, presentation, risk stratification and management. These differences shed new lights on the possibility to consider HF as a prototype of the impact of gender/sex issue in cardiovascular medicine. A call for action and future strategies might help in the achievement of a cleaver patient-care.

Section: Heart Failure As a Prototype For Considering The Importance Of The Sex/gender Issue In Cardiovascular Medicinementioning

confidence: 99%

Section: Heart Failure As a Prototype For Considering The Importance Of The Sex/gender Issue In Cardiovascular Medicinementioning

confidence: 99%

The impact of gender in cardiovascular medicine: Lessons from the gender/sex-issue in heart failure

Marra

Salzano

Arcopinto

et al. 2018

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“…The interplay between hormones and the cardiovascular system is complex [11,66,[67][68][69][70][71][72][73][74][75][76]. The importance of the somatotropic axis in cardiovascular homeostasis were extensively described in the last 3 decades.…”

Section: Future Prospective and Conclusionmentioning

confidence: 99%

The impairment of the Growth Hormone/Insulin-like growth factor 1 (IGF-1) axis in heart failure: A possible target for future therapy

Piccioli¹,

Arcopinto²,

Salzano

et al. 2018

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Hormonal abnormalities are quite common in chronic heart failure (CHF). The most studied hormonal axis in CHF is the impairment of Growth Hormone (GH)/Insulin Growth Factor-1(IGF-1), which in turn is defined either by a blunted response to GH stimulation test or low serum IGF-1 values. Several independent groups reported that the presence of an abnormal GH/IGF-1 status in CHF is associated with a more severe disease, impaired functional capacity and reduced Survival rates. After the first encouraging results, double -blind controlled trials showed a neutral effect of the GH administration in patients. However, further studies reported positive results, when a GH-therapy is implemented only in those patients presenting a GH deficiency (replacement therapy).

“…Considering the important topic of sex differences in disease [42][43][44][45][46][47], the effect of testosterone treatment has been investigated also in female populations. In 36 female patients treated with testosterone (300 mg, transdermal patch, twice per week), an improvement in 6-minute walking distance and peak oxygen consumption was observed.…”

Section: Discussionmentioning

confidence: 99%

Testosterone treatment in chronic heart failure. Review of literature and future perspectives

D’Assante

Piccioli

Stagnaro

et al. 2018

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Mounting evidence suggests that hormonal deficiencies (HD) have an important role in chronic heart failure (CHF). In particular, androgen depletion is common in men with CHF and is associated with increased morbidity and mortality. This review summarizes the current understanding of the complex relationship between CHF and testosterone, focusing on evidence derived from clinical trials that have investigated the role of testosterone in the treatment of CHF. A greater comprehension of this area will allow researchers and clinicians to plan future studies that improve current strategies to reduce mortality in this high-risk population. Online databases PubMed (Medline), Web of Science, and Scopus were searched for manuscripts published prior to June 2018 using key words "heart failure" AND "testosterone" OR "anabolism" OR "hormone" OR "replacement treatment". Manuscripts were collated, studied and carried forward for discussion where appropriate. In summary, findings from the literature demonstrate that testosterone treatment in CHF is a promising topic that requires further investigation.