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妇科疾病的心血管影响:弥合妇科与心脏病学之间的差距

Cardiovascular Implications of Gynecological Disorders: Bridging the Gap Between Gynecology and Cardiology.

作者信息

Tripathi Ashish, Arsha Sanjana, Thapa Anish, Thapa Sangharsha, Chand Swati, Frishman William H, Aronow Wilbert S

机构信息

From the Department of Medicine, Westchester Medical Center, Valhalla, NY.

Department of Medicine, Universal College of Medical Sciences, Bhairhawa, Nepal.

出版信息

Cardiol Rev. 2024 Jul 30. doi: 10.1097/CRD.0000000000000759.

Abstract

Gynecological disorders such as endometriosis, polycystic ovary syndrome, and gynecological cancers are increasingly recognized as potential risk factors for cardiovascular disease (CVD). Endometriosis, a chronic inflammatory condition, exhibits shared pathogenic mechanisms with CVD, including endothelial dysfunction and an atherogenic lipid profile. Emerging evidence suggests a link between endometriosis and an elevated risk of cardiovascular events such as myocardial infarction, ischemic heart disease, and hypertension. Polycystic ovary syndrome, characterized by hormonal imbalances and metabolic derangements, is associated with an increased risk of hypertension, myocardial infarction, and structural cardiac abnormalities, even after controlling for obesity. Gynecological cancers, such as ovarian, endometrial, and cervical cancers, are also associated with an increased burden of cardiovascular comorbidities and mortality. Cancer treatments, including chemotherapy and radiation therapy, can further contribute to cardiovascular toxicity. Understanding the interplay between gynecological disorders and CVD is crucial for identifying high-risk individuals, implementing preventive strategies, and providing comprehensive care. A multidisciplinary approach involving gynecologists, cardiologists, and other specialists is essential for optimizing the management of these complex conditions and improving overall patient outcomes.

摘要

子宫内膜异位症、多囊卵巢综合征和妇科癌症等妇科疾病日益被视为心血管疾病(CVD)的潜在危险因素。子宫内膜异位症是一种慢性炎症性疾病,与心血管疾病具有共同的致病机制,包括内皮功能障碍和动脉粥样硬化性脂质谱。新出现的证据表明,子宫内膜异位症与心血管事件风险升高之间存在联系,如心肌梗死、缺血性心脏病和高血压。多囊卵巢综合征以激素失衡和代谢紊乱为特征,即使在控制肥胖因素后,仍与高血压、心肌梗死和心脏结构异常的风险增加有关。妇科癌症,如卵巢癌、子宫内膜癌和宫颈癌,也与心血管合并症负担和死亡率增加有关。包括化疗和放疗在内的癌症治疗会进一步导致心血管毒性。了解妇科疾病与心血管疾病之间的相互作用对于识别高危个体、实施预防策略和提供全面护理至关重要。涉及妇科医生、心脏病专家和其他专家的多学科方法对于优化这些复杂疾病的管理和改善患者总体预后至关重要。

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