Sex differences in the presentation, pathophysiology, and prognosis of heart failure with preserved ejection fraction

Borlaug BA, Sharma K, Shah SJ, Ho JE (2023) Heart failure with preserved ejection fraction: JACC scientific statement. J Am Coll Cardiol 81(18):1810–1834. https://doi.org/10.1016/j.jacc.2023.01.049

Article  PubMed  Google Scholar 

Shah SJ, Kitzman DW, Borlaug BA et al (2016) Phenotype-specific treatment of heart failure with preserved ejection fraction: a multiorgan roadmap. Circulation 134(1):73–90. https://doi.org/10.1161/circulationaha.116.021884

Article  PubMed  PubMed Central  Google Scholar 

Sotomi Y, Hikoso S, Nakatani D et al (2021) Sex differences in heart failure with preserved ejection fraction. J Am Heart Assoc 10(5):e018574. https://doi.org/10.1161/jaha.120.018574

Article  CAS  PubMed  PubMed Central  Google Scholar 

Smereka Y, Ezekowitz JA (2024) HFpEF and sex: understanding the role of sex differences. Can J Physiol Pharmacol 102(8):465–475. https://doi.org/10.1139/cjpp-2023-0403

Article  CAS  PubMed  Google Scholar 

Beale AL, Meyer P, Marwick TH, Lam CSP, Kaye DM (2018) Sex differences in cardiovascular pathophysiology: why women are overrepresented in heart failure with preserved ejection fraction. Circulation 138(2):198–205. https://doi.org/10.1161/circulationaha.118.034271

Article  PubMed  Google Scholar 

Sabbatini AR, Kararigas G (2020) Menopause-related estrogen decrease and the pathogenesis of HFpEF: JACC review topic of the week. J Am Coll Cardiol 75(9):1074–1082. https://doi.org/10.1016/j.jacc.2019.12.049

Article  CAS  PubMed  Google Scholar 

Lee SU, Park JY, Hong S et al (2024) Risk factors for pregnancy-associated heart failure with preserved ejection fraction and adverse pregnancy outcomes: a cross-sectional study. BMC Pregnancy Childbirth 24(1):211. https://doi.org/10.1186/s12884-024-06402-5

Article  PubMed  PubMed Central  Google Scholar 

Briller JE, Mogos MF, Muchira JM, Piano MR (2021) Pregnancy associated heart failure with preserved ejection fraction: risk factors and maternal morbidity. J Card Fail 27(2):143–152. https://doi.org/10.1016/j.cardfail.2020.12.020

Article  PubMed  Google Scholar 

Tibrewala A, Yancy CW (2019) Heart failure with preserved ejection fraction in women. Heart Fail Clin 15(1):9–18. https://doi.org/10.1016/j.hfc.2018.08.002

Article  PubMed  Google Scholar 

Owan TE, Hodge DO, Herges RM, Jacobsen SJ, Roger VL, Redfield MM (2006) Trends in prevalence and outcome of heart failure with preserved ejection fraction. New Engl J Med 355(3):251–259. https://doi.org/10.1056/NEJMoa052256

Article  CAS  PubMed  Google Scholar 

Redfield MM, Borlaug BA (2023) Heart failure with preserved ejection fraction: a review. JAMA 329(10):827–838. https://doi.org/10.1001/jama.2023.2020

Article  PubMed  Google Scholar 

Pepine CJ, Merz CNB, El Hajj S et al (2020) Heart failure with preserved ejection fraction: similarities and differences between women and men. Int J Cardiol 304:101–108. https://doi.org/10.1016/j.ijcard.2020.01.003

Article  PubMed  Google Scholar 

Pandey A, Omar W, Ayers C et al (2018) Sex and race differences in lifetime risk of heart failure with preserved ejection fraction and heart failure with reduced ejection fraction. Circulation 137(17):1814-1823. https://doi.org/10.1161/circulationaha.117.031622

Toth PP, Gauthier D (2021) Heart failure with preserved ejection fraction: disease burden for patients, caregivers, and the health-care system. Postgrad Med 133(2):140–145. https://doi.org/10.1080/00325481.2020.1842621

Article  PubMed  Google Scholar 

Dewan P, Rørth R, Raparelli V et al (2019) Sex-related differences in heart failure with preserved ejection fraction. Circ Heart Fail 12(12):e006539. https://doi.org/10.1161/circheartfailure.119.006539

Deswal A, Bozkurt B (2006) Comparison of morbidity in women versus men with heart failure and preserved ejection fraction. Am J Cardiol 97(8):1228–1231. https://doi.org/10.1016/j.amjcard.2005.11.042

Article  PubMed  Google Scholar 

Lam CS, Carson PE, Anand IS et al (2012) Sex differences in clinical characteristics and outcomes in elderly patients with heart failure and preserved ejection fraction: the Irbesartan in heart failure with preserved ejection fraction (I-PRESERVE) trial. Circ Heart Fail 5(5):571–578. https://doi.org/10.1161/circheartfailure.112.970061

Article  CAS  PubMed  PubMed Central  Google Scholar 

O'Neal WT, Sandesara P, Hammadah M et al (2017) Gender differences in the risk of adverse outcomes in patients with atrial fibrillation and heart failure with preserved ejection fraction. Am J Cardiol 119(11):1785–1790. https://doi.org/10.1016/j.amjcard.2017.02.045

Article  PubMed  PubMed Central  Google Scholar 

Eaton CB, Pettinger M, Rossouw J et al (2016) Risk factors for incident hospitalized heart failure with preserved versus reduced ejection fraction in a multiracial cohort of postmenopausal women. Circ Heart Fail 9(10). https://doi.org/10.1161/circheartfailure.115.002883

Chang PP, Wruck LM, Shahar E et al (2018) Trends in hospitalizations and survival of acute decompensated heart failure in four US communities (2005-2014): ARIC study community surveillance. Circulation 138(1):12–24. https://doi.org/10.1161/circulationaha.117.027551

Article  PubMed  PubMed Central  Google Scholar 

Upadhya B, Kitzman DW (2020) Heart failure with preserved ejection fraction: new approaches to diagnosis and management. Clin Cardiol 43(2):145–155. https://doi.org/10.1002/clc.23321

Article  PubMed  Google Scholar 

Lee DS, Gona P, Albano I et al (2011) A systematic assessment of causes of death after heart failure onset in the community: impact of age at death, time period, and left ventricular systolic dysfunction. Circ Heart Fail 4(1):36–43. https://doi.org/10.1161/circheartfailure.110.957480

Article  PubMed  Google Scholar 

Goyal P, Paul T, Almarzooq ZI et al (2017) Sex- and race-related differences in characteristics and outcomes of hospitalizations for heart failure with preserved ejection fraction. J Am Heart Assoc 6(4). https://doi.org/10.1161/jaha.116.003330

Duca F, Zotter-Tufaro C, Kammerlander AA et al (2018) Gender-related differences in heart failure with preserved ejection fraction. Sci Rep 8(1):1080. https://doi.org/10.1038/s41598-018-19507-7

Article  CAS  PubMed  PubMed Central  Google Scholar 

Pagel PS, Tawil JN, Boettcher BT et al (2021) Heart failure with preserved ejection fraction: a comprehensive review and update of diagnosis, pathophysiology, treatment, and perioperative implications. J Cardiothorac Vasc Anesth 35(6):1839–1859. https://doi.org/10.1053/j.jvca.2020.07.016

Article  PubMed  Google Scholar 

Gorter TM, van Veldhuisen DJ, Bauersachs J et al (2018) Right heart dysfunction and failure in heart failure with preserved ejection fraction: mechanisms and management. Position statement on behalf of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail 20(1):16–37. https://doi.org/10.1002/ejhf.1029

Article  PubMed  Google Scholar 

Melenovsky V, Hwang SJ, Lin G, Redfield MM, Borlaug BA (2014) Right heart dysfunction in heart failure with preserved ejection fraction. Eur Heart J 35(48):3452–3462. https://doi.org/10.1093/eurheartj/ehu193

Article  CAS  PubMed  PubMed Central  Google Scholar 

Inciardi RM, Abanda M, Shah AM et al (2023) Right ventricular function and pulmonary coupling in patients with heart failure and preserved ejection fraction. J Am Coll Cardiol 82(6):489–499. https://doi.org/10.1016/j.jacc.2023.05.010

Article  PubMed  Google Scholar 

Carbone S, Popovic D, Lavie CJ, Arena R (2017) Obesity, body composition and cardiorespiratory fitness in heart failure with preserved ejection fraction. Future Cardiol 13(5):451–463. https://doi.org/10.2217/fca-2017-0023

Article  CAS  PubMed  Google Scholar 

Dhakal BP, Malhotra R, Murphy RM et al (2015) Mechanisms of exercise intolerance in heart failure with preserved ejection fraction: the role of abnormal peripheral oxygen extraction. Circ Heart Fail 8(2):286–294. https://doi.org/10.1161/circheartfailure.114.001825

Article  PubMed  Google Scholar 

Faxén UL, Hage C, Donal E, Daubert JC, Linde C, Lund LH (2018) Patient reported outcome in HFpEF: sex-specific differences in quality of life and association with outcome. Int J Cardiol 267:128–132. https://doi.org/10.1016/j.ijcard.2018.04.102

Article  PubMed  Google Scholar 

Honigberg MC, Lau ES, Jones AD et al (2020) Sex differences in exercise capacity and quality of life in heart failure with preserved ejection fraction: a secondary analysis of the RELAX and NEAT-HFpEF trials. J Cardiac Fail 26(3):276–280. https://doi.org/10.1016/j.cardfail.2020.01.001

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