Heredia-Campos Gloria, Rodríguez-Gómez Maria Elena, Perea-Armijo Jorge, González-Manzanares Rafael, Castillo-Domínguez Juan Carlos, Delgado-Ortega Mónica, Crespin-Crespin Manuel, Ruiz-Ortiz Martín, Mesa-Rubio Dolores, Ladera-Santos Diana, Iglesias-López Rafael, Calvo-Gutiérrez Laura, Velarde-Morales Laura, Pan-Álvarez Osorio Manuel, Anguita-Sánchez Manuel, López-Aguilera José
Unidad de Insuficiencia Cardiaca, Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, España; Instituto de Investigación Biomédica de Córdoba, IMIBIC, Córdoba, España.
Servicio de Cardiología, Hospital Universitario de Torrecárdenas, Almería, España.
Med Clin (Barc). 2025 Jun 27;164(12):106962. doi: 10.1016/j.medcli.2025.106962. Epub 2025 May 9.
It is estimated that 30-50% of patients with heart failure (HF) with reduced ejection fraction (HFrEF) are women. This population appears to differ in terms of clinical characteristics, aetiology and treatment optimisation compared to men. Our main objective was to analyse these considerations, the influence of female sex on cardiac remodelling and neurohormonal response, as well as their impact on medium- to long-term prognosis.
Retrospective study of a cohort of HFrEF patients from real clinical practice. A comparative analysis was performed between male and female patients.
409 patients were analysed, a total of 106 females (25.4%), with a higher mean age than males (71.4±13.8 vs. 66±11.9; P<.001), higher prevalence of de novo HF (66.6% vs. 51.5%; P=.009), with a shorter HF evolution time (18.4±42.6 vs. 42.8±75.6 months; P=.001). Without significant differences in treatment optimisation, women had better cardiac remodelling at follow-up, as well as better neurohormonal response, with higher percentage reduction of NT-proBNP (-61,9% vs. -54,2%; P<.01), and of CA125 (-63,4% vs. -50,9%; P<.01]. With a median follow-up of 5years, there were no differences in hospital readmissions or HF mortality in both sexes.
Women with HFrEF have different clinical and aetiological characteristics compared to men. In evolution, they have better cardiac remodelling and neurohormonal response, although this has no impact on prognosis, readmission or mortality due to heart failure.
据估计，射血分数降低的心力衰竭（HFrEF）患者中30%-50%为女性。与男性相比，这一人群在临床特征、病因及治疗优化方面似乎有所不同。我们的主要目标是分析这些因素、女性性别对心脏重塑和神经激素反应的影响，以及它们对中长期预后的影响。
对来自实际临床实践的HFrEF患者队列进行回顾性研究。对男性和女性患者进行了比较分析。
共分析了409例患者，其中女性106例（25.4%），平均年龄高于男性（71.4±13.8岁 vs. 66±11.9岁；P<.001），新发心力衰竭的患病率更高（66.6% vs. 51.5%；P=.009），心力衰竭病程更短（18.4±42.6个月 vs. 42.8±75.6个月；P=.001）。在治疗优化方面无显著差异，但女性在随访时心脏重塑更好，神经激素反应也更好，NT-proBNP降低百分比更高（-61.9% vs. -54.2%；P<.01），CA125降低百分比更高（-63.4% vs. -50.9%；P<.01）。中位随访5年，两性在住院再入院率或心力衰竭死亡率方面无差异。
与男性相比，HFrEF女性具有不同的临床和病因特征。在病程中，她们具有更好的心脏重塑和神经激素反应，尽管这对心力衰竭的预后、再入院率或死亡率没有影响。
