Ferreira Cláudia, Trindade Fábio, Ferreira Rita, Neves João Sérgio, Leite-Moreira Adelino, Amado Francisco, Santos Mário, Nogueira-Ferreira Rita
LAQV-REQUIMTE, Department of Chemistry, University of Aveiro, Aveiro, Portugal.
Department of Surgery and Physiology, Cardiovascular R&D Center (UnIC), Faculty of Medicine, University of Porto, Porto, Portugal.
J Mol Med (Berl). 2022 Feb;100(2):245-267. doi: 10.1007/s00109-021-02169-w. Epub 2021 Nov 23.
Heart failure (HF) is growing in prevalence, due to an increase in aging and comorbidities. Heart failure with reduced ejection fraction (HFrEF) is more common in men, whereas heart failure with preserved ejection fraction (HFpEF) has a higher prevalence in women. However, the reasons for these epidemiological trends are not clear yet. Since HFpEF affects mostly postmenopausal women, sex hormones should play a pivotal role in HFpEF development. Furthermore, for HFpEF, contrary to HFrEF, effective therapeutic approaches are missing. Interestingly, studies evidenced that some therapies can have better results in women than in HFpEF men, emphasizing the necessity of understanding these observations at a molecular level. Thus, herein, we review the molecular mechanisms of estrogen and androgen actions in the heart in physiological conditions and explain how its dysregulation can lead to disease development. This clarification is essential in the road for an effective personalized management of HF, particularly HFpEF, towards the development of sex-specific therapeutic approaches.
由于老龄化和合并症的增加，心力衰竭（HF）的患病率正在上升。射血分数降低的心力衰竭（HFrEF）在男性中更为常见，而射血分数保留的心力衰竭（HFpEF）在女性中的患病率更高。然而，这些流行病学趋势的原因尚不清楚。由于HFpEF主要影响绝经后女性，性激素应在HFpEF的发展中起关键作用。此外，与HFrEF相反，HFpEF缺乏有效的治疗方法。有趣的是，研究表明，一些治疗方法在女性中比在HFpEF男性中效果更好，这强调了在分子水平上理解这些观察结果的必要性。因此，在本文中，我们回顾了生理条件下雌激素和雄激素在心脏中的作用分子机制，并解释了其失调如何导致疾病发展。这种澄清对于有效个性化管理HF，特别是HFpEF，朝着开发性别特异性治疗方法的方向发展至关重要。
