Sex-Related Differences in Characteristics and Therapy of Heart Failure Patients

Abstract

Aim: To determine the differences in comorbidities, therapy and echocardiographic measures among patients hospitalized for heart failure relative to gender. Methods: The study included patients hospitalized for heart failure at the Department of Cardiovascular Diseases of the Clinical Hospital Center Osijek in the period from 1 January 2020 to 30 March 2021. Results: There were 200 patients included in the study, of which 100 (50%) were male and 100 (50%) were female. Female patients were older, while male patients more frequently had a history of coronary artery disease. Men had a higher dose of loop diuretic on admission to the hospital. No significant difference was found in the representation of beta blockers and ACE inhibitors in therapy with regard to gender. On the other hand, men more frequently used MRA, sacubitril/valsartan and antiplatelet medication at hospital admission. Male patients had a larger left ventricular end-diastolic diameter, left ventricular end-systolic diameter and a lower left ventricular ejection fraction (EF). Regarding the type of heart failure according to EF, 72% of men had HFrEF, 20% HFmrEF and 8% HFpEF. In women, 47% had HFrEF, 33% HFmrEF and 20% HFpEF. During hospitalization due to heart failure, 22 patients died, an equal number of men and women. Conclusion: This research confirmed the differences in risk factors and pathophysiology of heart failure between males and females. Medicine is progressing towards an individual approach to each patient, so further research will be needed to find the best therapy for both male and female patients. Sažetak Cilj: Odrediti razlike u komorbiditetima, terapiji i ehokardiografskim mjerenjima među pacijentima hospitaliziranima zbog zatajenja srca u odnosu na spol. Metode: Studija je uključila pacijente hospitalizirane zbog zatajenja srca na Odjelu za kardiovaskularne bolesti Kliničkog bolničkog centra Osijek u razdoblju od 1. siječnja 2020. do 30. ožujka 2021. godine. Rezultati: U studiju je bilo uključeno 200 pacijenata, od kojih je 100 (50 %) bilo muškaraca i 100 (50 %) žena. Ženske pacijentice bile su starije, dok su muškarci češće imali povijest koronarne arterijske bolesti. Muškarci su na prijemu u bolnicu primali višu dozu diuretika Henleove petlje. Nije pronađena značajna razlika u zastupljenosti beta blokatora i ACE inhibitora u terapiji s obzirom na spol. S druge strane, muškarci su češće koristili MRA, sakubitril/valsartan i antitrombocitne lijekove pri prijemu u bolnicu. Muški pacijenti imali su veći krajnji dijastolički promjer lijeve klijetke, krajnji sistolički promjer lijeve klijetke i nižu ejekcijsku frakciju (EF) lijeve klijetke. S obzirom na tip zatajenja srca prema EF-u, 72 % muškaraca je imalo HFrEF, 20 % HFmrEF, i 8 % HFpEF. Kod žena, 47 % ih je imalo HFrEF, 33 % HFmrEF i 20 % HFpEF. Tijekom hospitalizacije zbog zatajenja srca, umrla su 22 pacijenta, jednak broj muškaraca i žena. Zaključak: Ovo istraživanje potvrdilo je razlike u rizičnim čimbenicima i patofiziologiji zatajenja srca između muškaraca i žena. Medicina napreduje prema individualnom pristupu svakom pacijentu, stoga će biti potrebna daljnja istraživanja kako bi se pronašla najbolja terapija za muškarce i žene.

Keywords

• ejection fraction
• heart failure
• sex characteristics
• therapy