Taylor Anne L
Columbia University Medical Center, 630 W. 168th Street, PH 1-132, New York, NY, 10032, USA,
Curr Heart Fail Rep. 2015 Apr;12(2):187-95. doi: 10.1007/s11897-015-0252-x.
Heart failure (HF) is increasing in incidence globally, and approximately half of all HF patients are women. When women and men with HF are compared, there are significant differences in disease etiology, expression, outcomes, and perhaps, response to therapy. Hypertension rather than coronary artery disease is a more important etiology of HF in women, and HF with preserved left ventricular ejection fraction (HFPEF) is more common in women. Regardless of its etiology, women have better survival and less sudden cardiac death, but poorer quality of life with equivalent degrees of left ventricular dysfunction. Animal studies of myocardial response to stressors resulting in heart failure corroborate sex differences in ventricular remodeling, cellular morphology, and function. Despite the fact that women make up nearly 50 % of HF patients, their inclusion in randomized clinical trials has remained at about 20 %, with no trials including women as a prespecified subgroup for statistical analysis. Thus, the evidence base for treatment of HF in women is not robustly supported by sex-specific data.
心力衰竭（HF）在全球的发病率正在上升，所有HF患者中约有一半是女性。当比较患有HF的女性和男性时，在疾病病因、表现、预后以及可能对治疗的反应方面存在显著差异。高血压而非冠状动脉疾病是女性HF更重要的病因，左心室射血分数保留的心力衰竭（HFpEF）在女性中更为常见。无论病因如何，女性有更好的生存率和更少的心脏性猝死，但在同等程度的左心室功能障碍情况下生活质量较差。关于心肌对应激源导致心力衰竭反应的动物研究证实了心室重塑、细胞形态和功能方面的性别差异。尽管女性占HF患者近50%，但她们在随机临床试验中的纳入率仍约为20%，没有试验将女性作为预先指定的亚组进行统计分析。因此，针对女性HF治疗的证据基础并未得到充分的性别特异性数据支持。
