Smith Charlotte E R, Ni Haibo, Grandi Eleonora
Department of Pharmacology, University of California, Davis, California, USA; email:
Annu Rev Physiol. 2025 Feb;87(1):1-24. doi: 10.1146/annurev-physiol-022724-104938. Epub 2025 Feb 3.
The importance of biological sex on disease etiology and outcomes has long been underinvestigated. While recent focus on characterizing sex differences in cardiac pathophysiology has led to improved inclusion of both sexes in scientific studies and clinical trials, much is still unknown about underlying differences in normal cardiac physiology. This is particularly true for the atria, where the most common arrhythmia, atrial fibrillation (AF), occurs. AF is associated with adverse structural, electrophysiological, and calcium handling remodeling that leads to patient morbidity and mortality. Differences in the onset, prevalence, presentation, and prognosis of AF are known to differ between males and females, yet the sex-specific baseline phenotypes from which AF arises are not well characterized. This review examines what is currently known about sex differences in atrial physiology, the alterations that occur in AF, potential mechanisms underlying sex divergence, and the need for sex-targeted therapeutic strategies.
生物性别对疾病病因和预后的重要性长期以来一直未得到充分研究。虽然最近对心脏病理生理学中性别差异特征的关注已促使科学研究和临床试验更好地纳入了两性，但对于正常心脏生理学的潜在差异仍有许多未知之处。心房尤其如此，最常见的心律失常——心房颤动（AF）就发生在此处。AF与不良的结构、电生理和钙处理重塑相关，会导致患者发病和死亡。已知AF在发病、患病率、表现和预后方面存在性别差异，但引发AF的性别特异性基线表型尚未得到充分表征。本综述探讨了目前关于心房生理学性别差异、AF中发生的改变、性别差异的潜在机制以及针对性别的治疗策略需求的已知情况。
