Хроническая сердечная недостаточность: фокус на различия между мужчинами и женщинами

Обзор литературы посвящен анализу различий, связанных с полом пациентов, в этиологических факторах, клинической картине, объективных лабораторно-инструментальных признаках сердечной недостаточности. Приведен анализ эффективности медикаментозных и немедикаментозных методов лечения в зависимости от пола у пациентов с низкой и сохраненной фракцией выброса левого желудочка, что должно улучшить качество оказания помощи и исходы у пациентов с сердечной недостаточностью.

1. Драпкина О.М., Бойцов С.А., Омельяновский В.В., Концевая А.В., Лукьянов М.М., Игнатьева В.И. и др. Социально-экономический ущерб, обусловленный хронической сердечной недостаточностью, в Российской Федерации. Российский кардиологический журнал. 2021;26(6):81-9. DOI: 10.15829/1560-4071-2021-4490

2. Mohebi R, Chen C, Ibrahim NE, McCarthy CP, Gaggin HK, Singer DE et al. Cardiovascular Disease Projections in the United States Based on the 2020 Census Estimates. Journal of the American College of Cardiology. 2022;80(6):565–78. DOI: 10.1016/j.jacc.2022.05.033

3. Lam CSP, Arnott C, Beale AL, Chandramouli C, Hilfiker-Kleiner D, Kaye DM et al. Sex differences in heart failure. European Heart Journal. 2019;40(47):3859–3868c. DOI: 10.1093/eurheartj/ehz835

4. Lloyd-Jones DM, Larson MG, Leip EP, Beiser A, D’Agostino RB, Kannel WB et al. Lifetime risk for developing congestive heart failure: the Framingham Heart Study. Circulation. 2002;106(24):3068–72. DOI: 10.1161/01.cir.0000039105.49749.6f

5. Dunlay SM, Givertz MM, Aguilar D, Allen LA, Chan M, Desai AS et al. Type 2 Diabetes Mellitus and Heart Failure: A Scientific Statement From the American Heart Association and the Heart Failure Society of America: This statement does not represent an update of the 2017 ACC/AHA/HFSA heart failure guideline update. Circulation. 2019;140(7):e294–324. DOI: 10.1161/CIR.0000000000000691

6. Беленков Ю.Н., Мареев В.Ю., Агеев Ф.Т., Фомин И.В., Бадин Ю.В., Поляков Д.С. и др. Истинная распространенность ХСН в Европейской части Российской Федерации (ЭПОХА, госпитальный этап) Журнал Сердечная Недостаточность. 2011;12(2):63-8

7. Поляков Д.C., Фомин И.В., Беленков Ю.Н., Мареев В.Ю., Агеев Ф.Т., Артемьева Е.Г. и др. Хроническая сердечная недостаточность в Российской Федерации: что изменилось за 20 лет наблюдения? Результаты исследования ЭПОХА–ХСН. Кардиология. 2021;61(4):4-14. DOI: 10.18087/cardio.2021.4.n1628

8. Шляхто Е.В., Беленков Ю.Н., Бойцов С.А., Виллевальде С.В., Галявич А.С., Глезер М.Г. и др. Результаты промежуточного анализа проспективного наблюдательного многоцентрового регистрового исследования пациентов с хронической сердечной недостаточностью в Российской Федерации ‘ПРИОРИТЕТ-ХСН’: исходные характеристики и лечение первых включённых пациентов. Российский кардиологический журнал. 2023;28(10):93-103. DOI: 10.15829/1560-4071-2023-5593

9. Mosterd A, Hoes AW. Clinical epidemiology of heart failure. Heart. 2007;93(9):1137–46. DOI: 10.1136/hrt.2003.025270

10. Coutinho T, Pellikka PA, Bailey KR, Turner ST, Kullo IJ. Sex Differences in the Associations of Hemodynamic Load With Left Ventricular Hypertrophy and Concentric Remodeling. American Journal of Hypertension. 2016;29(1):73–80. DOI: 10.1093/ajh/hpv071

11. Прокофьева Е.Б., Глезер М.Г. Жесткость артериальной стенки и показатели центральной гемодинамики на фоне длительной комбинированной антигипертензивной терапии. Кардиология. 2015;55(4):19-24. DOI: 10.18565/cardio.2015.4.19-24

12. Haider AW, Larson MG, Franklin SS, Levy D. Systolic Blood Pressure, Diastolic Blood Pressure, and Pulse Pressure as Predictors of Risk for Congestive Heart Failure in the Framingham Heart Study. Annals of Internal Medicine. 2003;138(1):10–6. DOI: 10.7326/0003-4819-138-1-200301070-00006

13. Глезер М.Г. Артериальная гипертония: особенности течения и лечения у женщин. Лечебное дело. 2013;1:33-40

14. Huang G, Liu X-H, Zhang Y, Zhu Y-X, He Y, Wang T-B et al. Nocturnal hypertension and riser pattern are associated with heart failure re-hospitalization in patients with heart failure with preserved ejection fraction. Journal of Geriatric Cardiology. 2023;20(6):448–58. DOI: 10.26599/1671-5411.2023.06.003

15. Guerra S, Leri A, Wang X, Finato N, Di Loreto C, Beltrami CA et al. Myocyte Death in the Failing Human Heart Is Gender Dependent. Circulation Research. 1999;85(9):856–66. DOI: 10.1161/01. RES.85.9.856

16. Alloatti G, Penna C, Comità S, Tullio F, Aragno M, Biasi F et al. Aging, sex and NLRP3 inflammasome in cardiac ischaemic disease. Vascular Pharmacology. 2022;145:107001. DOI: 10.1016/j.vph.2022.107001

17. Van Blokland IV, Groot HE, Hendriks T, Assa S, Van Der Harst P. Sex differences in leukocyte profile in ST-elevation myocardial infarction patients. Scientific Reports. 2020;10(1):6851. DOI: 10.1038/s41598-020-63185-3

18. Cavasin MA, Tao Z, Menon S, Yang X-P. Gender differences in cardiac function during early remodeling after acute myocardial infarction in mice. Life Sciences. 2004;75(18):2181–92. DOI: 10.1016/j.lfs.2004.04.024

19. López-Palop R, Carrillo P, Lozano Í. Impact of Sex in the Incidence of Heart Failure in Patients with Chronic Coronary Syndrome. Current Heart Failure Reports. 2024;21(4):354–66. DOI: 10.1007/s11897-024-00663-z

20. Elia E, Bruno F, Crimi G, Wańha W, Leonardi S, Mauro M et al. Gender differences in the development of heart failure after acute coronary syndrome: Insight from the CORALYS registry. International Journal of Cardiology. 2024;397:131622. DOI: 10.1016/j.ijcard.2023.131622

21. La Vecchia G, Fumarulo I, Caffè A, Chiatto M, Montone RA, Aspromonte N. Microvascular Dysfunction across the Spectrum of Heart Failure Pathology: Pathophysiology, Clinical Features and Therapeutic Implications. International Journal of Molecular Sciences. 2024;25(14):7628. DOI: 10.3390/ijms25147628

22. Shah SJ, Lam CSP, Svedlund S, Saraste A, Hage C, Tan R-S et al. Prevalence and correlates of coronary microvascular dysfunction in heart failure with preserved ejection fraction: PROMIS-HFpEF. European Heart Journal. 2018;39(37):3439–50. DOI: 10.1093/eurheartj/ehy531

23. D’Amario D, Laborante R, Bianchini E, Ciliberti G, Paglianiti DA, Galli M et al. Impact of coronary microvascular dysfunction in heart failure with preserved ejection fraction: a meta‐analysis. ESC Heart Failure. 2024;11(4):2063–75. DOI: 10.1002/ehf2.14626

24. Paulus WJ, Tschope C. A novel paradigm for heart failure with preserved ejection fraction: comorbidities drive myocardial dysfunction and remodeling through coronary microvascular endothelial inflammation. Journal of the American College of Cardiology. 2013;62(4):263–71. DOI: 10.1016/j.jacc.2013.02.092

25. Pepine CJ, Anderson RD, Sharaf BL, Reis SE, Smith KM, Handberg EM et al. Coronary Microvascular Reactivity to Adenosine Predicts Adverse Outcome in Women Evaluated for Suspected Ischemia. Journal of the American College of Cardiology. 2010;55(25):2825–32. DOI: 10.1016/j.jacc.2010.01.054

26. Aimo A, Panichella G, Barison A, Maffei S, Cameli M, Coiro S et al. Sex-related differences in ventricular remodeling after myocardial infarction. International Journal of Cardiology. 2021;339:62–9. DOI: 10.1016/j.ijcard.2021.07.036

27. Álvarez-Zaballos S, Martínez-Sellés M. Impact of Sex and Diabetes in Patients with Heart Failure. Current Heart Failure Reports. 2024;21(4):389–95. DOI: 10.1007/s11897-024-00666-w

28. Hofer-Zeni S, Leutner M, Klimek P, Bellach L, Pavo N, Prausmüller S et al. Sex differences in the diagnostic algorithm of screening for heart failure by symptoms and NT-proBNP in patients with type 2 diabetes. Cardiovascular Diabetology. 2024;23(1):280. DOI: 10.1186/s12933-024-02360-6

29. Jiménez A, Vlacho B, Mata-Cases M, Real J, Mauricio D, Franch-Nadal J et al. Sex and age significantly modulate cardiovascular disease presentation in type 2 diabetes: a large population-based cohort study. Frontiers in Endocrinology. 2024;15:1344007. DOI: 10.3389/fendo.2024.1344007

30. Östgren CJ, Merlo J, Råstam L, Lindblad U, for Skaraborg Hypertension and Diabetes Project. Atrial fibrillation and its association with type 2 diabetes and hypertension in a Swedish community. Diabetes, Obesity and Metabolism. 2004;6(5):367–74. DOI: 10.1111/j.1462-8902.2004.00358.x

31. Choi J, Lee S, Choi E, Lee H, Han M, Ahn H-J et al. Accumulated hypertension burden on atrial fibrillation risk in diabetes mellitus: a nationwide population study. Cardiovascular Diabetology. 2023;22(1):12. DOI: 10.1186/s12933-023-01736-4

32. Arnautu D-A, Arnautu S-F, Tomescu M-C, Luca S, Luca C-T. Increased Left Atrial Stiffness is Significantly Associated with Paroxysmal Atrial Fibrillation in Diabetic Patients. Diabetes, Metabolic Syndrome and Obesity. 2023;16:2077–87. DOI: 10.2147/DMSO.S417675

33. Benjamin EJ, Wolf PA, D’Agostino RB, Silbershatz H, Kannel WB, Levy D. Impact of atrial fibrillation on the risk of death: the Framingham Heart Study. Circulation. 1998;98(10):946–52. DOI: 10.1161/01.cir.98.10.946

34. O’Neal WT, Sandesara P, Hammadah M, Venkatesh S, Samman-Tahhan A, Kelli HM et al. Gender Differences in the Risk of Adverse Outcomes in Patients With Atrial Fibrillation and Heart Failure With Preserved Ejection Fraction. The American Journal of Cardiology. 2017;119(11):1785–90. DOI: 10.1016/j.amjcard.2017.02.045

35. Winters J, Isaacs A, Zeemering S, Kawczynski M, Maesen B, Maessen J et al. Heart Failure, Female Sex, and Atrial Fibrillation Are the Main Drivers of Human Atrial Cardiomyopathy: Results From the CATCH ME Consortium. Journal of the American Heart Association. 2023;12(22):e031220. DOI: 10.1161/JAHA.123.031220

36. Yoshida K, Obokata M, Kurosawa K, Sorimachi H, Kurabayashi M, Negishi K. Effect of Sex Differences on the Association Between Stroke Risk and Left Atrial Anatomy or Mechanics in Patients With Atrial Fibrillation. Circulation: Cardiovascular Imaging. 2016;9(10):e004999. DOI: 10.1161/CIRCIMAGING.116.004999

37. Chen Y-Z, Qiao S-B, Hu F-H, Yuan J-S, Yang W-X, Cui J-G et al. Left ventricular remodeling and fibrosis: Sex differences and relationship with diastolic function in hypertrophic cardiomyopathy. European Journal of Radiology. 2015;84(8):1487–92. DOI: 10.1016/j.ejrad.2015.04.026

38. Akoum N, Mahnkopf C, Kholmovski EG, Brachmann J, Marrouche NF. Age and sex differences in atrial fibrosis among patients with atrial fibrillation. EP Europace. 2018;20(7):1086–92. DOI: 10.1093/europace/eux260

39. Li Z, Wang Z, Yin Z, Zhang Y, Xue X, Han J et al. Gender differences in fibrosis remodeling in patients with long-standing persistent atrial fibrillation. Oncotarget. 2017;8(32):53714–29. DOI: 10.18632/oncotarget.16342

40. Patel D, Mohanty P, Di Biase L, Sanchez JE, Shaheen MH, Burkhardt JD et al. Outcomes and complications of catheter ablation for atrial fibrillation in females. Heart Rhythm. 2010;7(2):167–72. DOI: 10.1016/j.hrthm.2009.10.025

41. Dewan P, Rørth R, Jhund PS, Shen L, Raparelli V, Petrie MC et al. Differential Impact of Heart Failure With Reduced Ejection Fraction on Men and Women. Journal of the American College of Cardiology. 2019;73(1):29–40. DOI: 10.1016/j.jacc.2018.09.081

42. Dewan P, Rørth R, Raparelli V, Campbell RT, Shen L, Jhund PS et al. Sex-Related Differences in Heart Failure With Preserved Ejection Fraction. Circulation: Heart Failure. 2019;12(12):e006539. DOI: 10.1161/CIRCHEARTFAILURE.119.006539

43. Farooqui N, Killian JM, Smith J, Redfield MM, Dunlay SM. Advanced Heart Failure Characteristics and Outcomes in Women and Men. Journal of the American Heart Association. 2024;13(13):e033374. DOI: 10.1161/JAHA.123.033374

44. Hansen AL, Søndergaard MM, Hlatky MA, Vittinghof E, Nah G, Stefanick ML et al. Adverse Pregnancy Outcomes and Incident Heart Failure in the Women’s Health Initiative. JAMA Network Open. 2021;4(12):e2138071. DOI: 10.1001/jamanetworkopen. 2021.38071

45. Keskin M, Avşar Ş, Hayıroğlu Mİ, Keskin T, Börklü EB, Kaya A et al. Relation of the Number of Parity to Left Ventricular Diastolic Function in Pregnancy. The American Journal of Cardiology. 2017;120(1):154–9. DOI: 10.1016/j.amjcard.2017.03.244

46. Kaur G, Lau E. Sex differences in heart failure with preserved ejection fraction: From traditional risk factors to sex-specific risk factors. Women’s Health. 2022;18:17455057221140209. DOI: 10.1177/17455057221140209

47. Stutsman N, Habecker B, Pavlovic N, Jurgens CY, Woodward WR, Lee CS et al. Sympathetic dysfunction is associated with worse fatigue and early and subtle symptoms in heart failure: an exploratory sex-stratified analysis. European Journal of Cardiovascular Nursing. 2024;23(5):532–9. DOI: 10.1093/eurjcn/zvad121

48. Da Silva LM, Coy‐Canguçu A, Paim LR, Bau AA, Nicolela Geraldo Martins C, Pinheiro S et al. Impaired Cardiac Sympathetic Activity Is Associated With Myocardial Remodeling and Established Biomarkers of Heart Failure. Journal of the American Heart Association. 2024;13(14):e035264. DOI: 10.1161/JAHA.124.035264

49. Sayegh ALC, Fan J, Vianna LC, Dawes M, Paton JFR, Fisher JP. Sex differences in the sympathetic neurocirculatory responses to chemoreflex activation. The Journal of Physiology. 2022;600(11):2669–89. DOI: 10.1113/JP282327

50. Yang X, Wen Y, Peng H, Zhu H, Wang WE, Zhou J. Gender Differences in Anxiety, Depression, Insomnia, and Quality of Life in Heart Failure With Preserved Ejection Fraction: A Multicenter, Cross-sectional Study. Journal of Cardiovascular Nursing. 2023;38(5):425–32. DOI: 10.1097/JCN.0000000000000951

51. Truby LK, O’Connor C, Fiuzat M, Stebbins A, Coles A, Patel CB et al. Sex Differences in Quality of Life and Clinical Outcomes in Patients With Advanced Heart Failure: Insights From the PAL-HF Trial. Circulation: Heart Failure. 2020;13(4):e006134. DOI: 10.1161/CIRCHEARTFAILURE.119.006134

52. Sugimoto T, Dulgheru R, Bernard A, Ilardi F, Contu L, Addetia K et al. Echocardiographic reference ranges for normal left ventricular 2D strain: results from the EACVI NORRE study. European Heart Journal - Cardiovascular Imaging. 2017;18(8):833–40. DOI: 10.1093/ehjci/jex140

53. Министерство Здравоохранения Российской Федерации. Клинические рекомендации. Хроническая сердечная недостаточность. 2024. Доступно на: https://cr.minzdrav.gov.ru/schema/156_2

54. McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. European Heart Journal. 2021;42(36):3599–726. DOI: 10.1093/eurheartj/ehab368

55. Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM et al. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/ American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022;145(18):e895–1032. DOI: 10.1161/CIR.0000000000001063

56. Mueller C, McDonald K, de Boer RA, Maisel A, Cleland JGF, Kozhuharov N et al. Heart Failure Association of the European Society of Cardiology practical guidance on the use of natriuretic peptide concentrations. European Journal of Heart Failure. 2019;21(6):715–31. DOI: 10.1002/ejhf.1494

57. Hildebrandt P, Collinson PO, Doughty RN, Fuat A, Gaze DC, Gustafsson F et al. Age-dependent values of N-terminal pro-Btype natriuretic peptide are superior to a single cut-point for ruling out suspected systolic dysfunction in primary care. European Heart Journal. 2010;31(15):1881–9. DOI: 10.1093/eurheartj/ehq163

58. Shetty NS, Patel N, Gaonkar M, Li P, Arora G, Arora P. Natriuretic Peptide Normative Levels and Deficiency. JACC: Heart Failure. 2024;12(1):50–63. DOI: 10.1016/j.jchf.2023.07.018

59. Aimo A, Januzzi JL, Vergaro G, Clerico A, Latini R, Meessen J et al. Revisiting the obesity paradox in heart failure: Per cent body fat as predictor of biomarkers and outcome. European Journal of Preventive Cardiology. 2019;26(16):1751–9. DOI: 10.1177/2047487319852809

60. Vergaro G, Gentile F, Meems LMG, Aimo A, Januzzi JL, Richards AM et al. NT-proBNP for Risk Prediction in Heart Failure: Identification of Optimal Cut offs Across Body Mass Index Categories. JACC: Heart Failure. 2021;9(9):653–63. DOI: 10.1016/j.jchf.2021.05.014

61. Pieske B, Tschöpe C, de Boer RA, Fraser AG, Anker SD, Donal E et al. How to diagnose heart failure with preserved ejection fraction: the HFA–PEFF diagnostic algorithm: a consensus recommendation from the Heart Failure Association (HFA) of the European Society of Cardiology (ESC). European Heart Journal. 2019;40(40):3297–317. DOI: 10.1093/eurheartj/ehz641

62. Franke J, Lindmark A, Hochadel M, Zugck C, Koerner E, Keppler J et al. Gender aspects in clinical presentation and prognostication of chronic heart failure according to NT-proBNP and the Heart Failure Survival Score. Clinical Research in Cardiology. 2015;104(4):334–41. DOI: 10.1007/s00392-014-0786-z

63. Cesaroni G, Mureddu GF, Agabiti N, Mayer F, Stafoggia M, Forastiere F et al. Sex differences in factors associated with heart failure and diastolic left ventricular dysfunction: a cross-sectional population-based study. BMC Public Health. 2021;21(1):415. DOI: 10.1186/s12889-021-10442-3

64. Willeit P, Kaptoge S, Welsh P, Butterworth AS, Chowdhury R, Spackman SA et al. Natriuretic peptides and integrated risk assessment for cardiovascular disease: an individual-participant-data meta-analysis. The Lancet Diabetes & Endocrinology. 2016;4(10):840–9. DOI: 10.1016/S2213-8587(16)30196-6

65. Kim H-L, Kim M-A, Choi D-J, Han S, Jeon E-S, Cho M-C et al. Gender Difference in the Prognostic Value of N-Terminal Pro-B Type Natriuretic Peptide in Patients With Heart Failure - A Report From the Korean Heart Failure Registry (KorHF). Circulation Journal. 2017;81(9):1329–36. DOI: 10.1253/circj.CJ-16-1345

66. Rudolf H, Mügge A, Trampisch HJ, Scharnagl H, März W, Kara K. NT-proBNP for risk prediction of cardiovascular events and all-cause mortality: The getABI-study. IJC Heart & Vasculature. 2020;29:100553. DOI: 10.1016/j.ijcha.2020.100553

67. Daubert MA, Yow E, Barnhart HX, Piña IL, Ahmad T, Leifer E et al. Differences in NT‐proBNP Response and Prognosis in Men and Women With Heart Failure With Reduced Ejection Fraction. Journal of the American Heart Association. 2021;10(10):e019712. DOI: 10.1161/JAHA.120.019712

68. Hamaguchi S, Kinugawa S, Sobirin MA, Goto D, Tsuchihashi-Makaya M, Yamada S et al. Mode of Death in Patients With Heart Failure and Reduced vs. Preserved Ejection Fraction: – Report From the Registry of Hospitalized Heart Failure Patients. Circulation Journal. 2012;76(7):1662–9. DOI: 10.1253/circj.CJ-11-1355

69. Cleland JGF, Bunting KV, Flather MD, Altman DG, Holmes J, Coats AJS et al. Beta-blockers for heart failure with reduced, midrange, and preserved ejection fraction: an individual patient-level analysis of double-blind randomized trials. European Heart Journal. 2018;39(1):26–35. DOI: 10.1093/eurheartj/ehx564

70. Mansur ADP, Del Carlo CH, Gonçalinho GHF, Avakian SD, Ribeiro LC, Ianni BM et al. Sex Differences in Heart Failure Mortality with Preserved, Mildly Reduced and Reduced Ejection Fraction: A Retrospective, Single-Center, Large-Cohort Study. International Journal of Environmental Research and Public Health. 2022;19(23):16171. DOI: 10.3390/ijerph192316171

71. Wang X, Vaduganathan M, Claggett BL, Hegde SM, Pabon M, Kulac IJ et al. Sex Differences in Characteristics, Outcomes, and Treatment Response With Dapagliflozin Across the Range of Ejection Fraction in Patients With Heart Failure: Insights From DAPA-HF and DELIVER. Circulation. 2023;147(8):624–34. DOI: 10.1161/CIRCULATIONAHA.122.062832

72. Liu D, Hu K, Schregelmann L, Hammel C, Lengenfelder BD, Ertl G et al. Determinants of ejection fraction improvement in heart failure patients with reduced ejection fraction. ESC Heart Failure. 2023;10(2):1358–71. DOI: 10.1002/ehf2.14303

73. Lam CSP, McEntegart M, Claggett B, Liu J, Skali H, Lewis E et al. Sex differences in clinical characteristics and outcomes after myocardial infarction: insights from the Valsartan in Acute Myocardial Infarction Trial (VALIANT). European Journal of Heart Failure. 2015;17(3):301–12. DOI: 10.1002/ejhf.238

74. Wang X, Jering KS, Cikes M, Tokmakova MP, Mehran R, Han Y et al. Sex Differences in Clinical Characteristics and Outcomes After Myocardial Infarction With Low Ejection Fraction: Insights From PARADISE‐MI. Journal of the American Heart Association. 2023;12(17):e028942. DOI: 10.1161/JAHA.122.028942

75. López-Vilella R, Marqués-Sulé E, Laymito Quispe RDP, Sánchez-Lázaro I, Donoso Trenado V, Martínez Dolz L et al. The Female Sex Confers Different Prognosis in Heart Failure: Same Mortality but More Readmissions. Frontiers in Cardiovascular Medicine. 2021;8:618398. DOI: 10.3389/fcvm.2021.618398

76. Antwi-Amoabeng D, Neelam V, Ulanja MB, Beutler BD, Gbadebo TD, Sugathan P. Association between Psychiatric Disorders and the Incidence of Heart Failure in Women. Journal of Cardiovascular Development and Disease. 2023;10(12):491. DOI: 10.3390/jcdd10120491

77. Hamatani Y, Iguchi M, Ikeyama Y, Kunugida A, Ogawa M, Yasuda N et al. Prevalence, Temporal Change, and Determinants of Anxiety and Depression in Hospitalized Patients With Heart Failure. Journal of Cardiac Failure. 2022;28(2):181–90. DOI: 10.1016/j.cardfail.2021.07.024

78. Aguilar-Iglesias L, Perez-Asensio A, Vilches-Miguel L, Jimenez-Mendez C, Diez-Villanueva P, Perez-Rivera J-A. Impact of Frailty on Heart Failure Prognosis: Is Sex Relevant? Current Heart Failure Reports. 2024;21(2):131–8. DOI: 10.1007/s11897-024-00650-4

79. Díez-Villanueva P, Jiménez-Méndez C, López-Lluva MT, Wasniewski S, Solís J, Fernández-Friera L et al. Heart Failure in the Elderly: the Role of Biological and Sociocultural Aspects Related to Sex. Current Heart Failure Reports. 2023;20(5):321–32. DOI: 10.1007/s11897-023-00619-9

80. Son Y, Won MH. Gender differences in the impact of health literacy on hospital readmission among older heart failure patients: A prospective cohort study. Journal of Advanced Nursing. 2020;76(6):1345–54. DOI: 10.1111/jan.14328

81. Kawai A, Nagatomo Y, Yukino-Iwashita M, Nakazawa R, Yumita Y, Taruoka A et al. Sex Differences in Cardiac and Clinical Phenotypes and Their Relation to Outcomes in Patients with Heart Failure. Journal of Personalized Medicine. 2024;14(2):201. DOI: 10.3390/jpm14020201

82. Гарганеева А.А., Тукиш О.В., Витт К.Н., Мареев Ю.В., Кужелева Е.А., Рябов В.В. и др. Хроническая сердечная недостаточность у пациентов, госпитализированных в кардиологический стационар в 2002 и 2021 годах: сравнительный анализ распространенности, клинического течения и медикаментозной терапии. Кардиология. 2024;64(3):3-10. DOI: 10.18087/cardio.2024.3.n2595

83. Shekelle PG, Rich MW, Morton SC, Atkinson ColSW, Tu W, Maglione M et al. Efficacy of angiotensin-converting enzyme inhibitors and beta-blockers in the management of left ventricular systolic dysfunction according to race, gender, and diabetic status. Journal of the American College of Cardiology. 2003;41(9):1529–38. DOI: 10.1016/S0735-1097(03)00262-6

84. Dewan P, Jackson A, Lam CSP, Pfeffer MA, Zannad F, Pitt B et al. Interactions between left ventricular ejection fraction, sex and effect of neurohumoral modulators in heart failure. European Journal of Heart Failure. 2020;22(5):898–901. DOI: 10.1002/ejhf.1776

85. Merrill M, Sweitzer NK, Lindenfeld J, Kao DP. Sex Differences in Outcomes and Responses to Spironolactone in Heart Failure With Preserved Ejection Fraction. JACC: Heart Failure. 2019;7(3):228–38. DOI: 10.1016/j.jchf.2019.01.003

86. Danielson C, Lileikyte G, Ouwerkerk W, S.P. Lam C, Erlinge D, Teng TK. Sex differences in efficacy of pharmacological therapies in heart failure with reduced ejection fraction: a meta‐analysis. ESC Heart Failure. 2022;9(4):2753–61. DOI: 10.1002/ehf2.13974

87. McMurray JJV, Packer M, Desai AS, Gong J, Lefkowitz MP, Rizkala AR et al. Angiotensin–niprilysin Inhibition versus enalapril in heart failure. New England Journal of Medicine. 2014;371(11):993–1004. DOI: 10.1056/NEJMoa1409077

88. Curtain JP, Jackson AM, Shen L, Jhund PS, Docherty KF, Petrie MC et al. Effect of sacubitril/valsartan on investigator‐reported ventricular arrhythmias in PARADIGM‐HF. European Journal of Heart Failure. 2022;24(3):551–61. DOI: 10.1002/ejhf.2419

89. Liu X-H, Wang G-L, Xu Q, Zhang L, Liu H-J. Effect of sacubitril/valsartan on the occurrence of cardiac arrhythmias and the risk of sudden cardiac death in heart failure: A meta-analysis of randomized controlled trials. Frontiers in Cardiovascular Medicine. 2022;9:943377. DOI: 10.3389/fcvm.2022.943377

90. Tan NY, Sangaralingham LR, Sangaralingham SJ, Yao X, Shah ND, Dunlay SM. Comparative Effectiveness of Sacubitril-Valsartan Versus ACE/ARB Therapy in Heart Failure With Reduced Ejection Fraction. JACC: Heart Failure. 2020;8(1):43–54. DOI: 10.1016/j.jchf.2019.08.003

91. Basile C, Paolillo S, Gargiulo P, Marzano F, Asile G, Parlati ALM et al. Sacubitril/valsartan reduces cardiac decompensation in heart failure with preserved ejection fraction: a meta-analysis. Journal of Cardiovascular Medicine. 2023;24(1):44–51. DOI: 10.2459/JCM.0000000000001411

92. Solomon SD, McMurray JJV, Anand IS, Ge J, Lam CSP, Maggioni AP et al. Angiotensin–Neprilysin Inhibition in Heart Failure with Preserved Ejection Fraction. New England Journal of Medicine. 2019;381(17):1609–20. DOI: 10.1056/NEJMoa1908655

93. McMurray JJV, Jackson AM, Lam CSP, Redfield MM, Anand IS, Ge J et al. Effects of Sacubitril-Valsartan Versus Valsartan in Women Compared With Men With Heart Failure and Preserved Ejection Fraction: Insights From PARAGON-HF. Circulation. 2020;141(5):338–51. DOI: 10.1161/CIRCULATIONAHA.119.044491

94. Young JB, Dunlap ME, Pfeffer MA, Probstfield JL, Cohen-Solal A, Dietz R et al. Mortality and morbidity reduction with Candesartan in patients with chronic heart failure and left ventricular systolic dysfunction: results of the CHARM low-left ventricular ejection fraction trials. Circulation. 2004;110(17):2618–26. DOI: 10.1161/01.CIR.0000146819.43235.A9

95. St. Pierre SR, Peirlinck M, Kuhl E. Sex Matters: A Comprehensive Comparison of Female and Male Hearts. Frontiers in Physiology. 2022;13:831179. DOI: 10.3389/fphys.2022.831179

96. Novella S, Pérez‐Cremades D, Mompeón A, Hermenegildo C. Mechanisms underlying the influence of oestrogen on cardiovascular physiology in women. The Journal of Physiology. 2019;597(19):4873–86. DOI: 10.1113/JP278063

97. Rivasi G, Coscarelli A, Capacci M, Ceolin L, Turrin G, Tortù V et al. Tolerability of Antihypertensive Medications: The Influence of Age. High Blood Pressure & Cardiovascular Prevention. 2024;31(3):261–9. DOI: 10.1007/s40292-024-00639-z

98. Kostis WJ, Shetty M, Chowdhury YS, Kostis JB. ACE Inhibitor-Induced Angioedema: a Review. Current Hypertension Reports. 2018;20(7):55. DOI: 10.1007/s11906-018-0859-x

99. Sohani ZN, Behlouli H, De Moura CS, Abrahamowicz M, Pilote L. Sex Differences in the Effectiveness of Angiotensin‐Converting Enzyme Inhibitors, Angiotensin II Receptor Blockers, and Sacubitril–Valsartan for the Treatment of Heart Failure. Journal of the American Heart Association. 2023;12(14):e028865. DOI: 10.1161/JAHA.122.028865

100. Rossello X, Ferreira JP, Pocock SJ, McMurray JJV, Solomon SD, Lam CSP et al. Sex differences in mineralocorticoid receptor antagonist trials: a pooled analysis of three large clinical trials. European Journal of Heart Failure. 2020;22(5):834–44. DOI: 10.1002/ejhf.1740

101. Rossello X, Ariti C, Pocock SJ, Ferreira JP, Girerd N, McMurray JJV et al. Impact of mineralocorticoid receptor antagonists on the risk of sudden cardiac death in patients with heart failure and left-ventricular systolic dysfunction: an individual patient-level meta-analysis of three randomized-controlled trials. Clinical Research in Cardiology. 2019;108(5):477–86. DOI: 10.1007/s00392-018-1378-0

102. Zaher W, Della Rocca DG, Pannone L, Boveda S, De Asmundis C, Chierchia G-B et al. Anti-Arrhythmic Effects of Heart Failure Guideline-Directed Medical Therapy and Their Role in the Prevention of Sudden Cardiac Death: From Beta-Blockers to Sodium-Glucose Cotransporter 2 Inhibitors and Beyond. Journal of Clinical Medicine. 2024;13(5):1316. DOI: 10.3390/jcm13051316

103. Kaddoura R, Madurasinghe V, Chapra A, Abushanab D, Al-Badriyeh D, Patel A. Beta-blocker therapy in heart failure with preserved ejection fraction (B-HFpEF): A systematic review and meta-analysis. Current Problems in Cardiology. 2024;49(3):102376. DOI: 10.1016/j.cpcardiol.2024.102376

104. Packer M, Anker SD, Butler J, Filippatos G, Ferreira JP, Pocock SJ et al. Effect of Empagliflozin on the Clinical Stability of Patients With Heart Failure and a Reduced Ejection Fraction: The EMPEROR-Reduced Trial. Circulation. 2021;143(4):326–36. DOI: 10.1161/CIRCULATIONAHA.120.051783

105. McMurray JJV, Solomon SD, Inzucchi SE, Køber L, Kosiborod MN, Martinez FA et al. Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction. New England Journal of Medicine. 2019;381(21):1995–2008. DOI: 10.1056/NEJMoa1911303

106. Packer M, Anker SD, Butler J, Filippatos G, Pocock SJ, Carson P et al. Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure. New England Journal of Medicine. 2020;383(15):1413–24. DOI: 10.1056/NEJMoa2022190

107. Butt JH, Docherty KF, Petrie MC, Schou M, Kosiborod MN, O’Meara E et al. Efficacy and Safety of Dapagliflozin in Men and Women With Heart Failure With Reduced Ejection Fraction: A Pre-specified Analysis of the Dapagliflozin and Prevention of Adverse Outcomes in Heart Failure Trial. JAMA Cardiology. 2021;6(6):678–89. DOI: 10.1001/jamacardio.2021.0379

108. Zannad F, Ferreira JP, Pocock SJ, Anker SD, Butler J, Filippatos G et al. SGLT2 inhibitors in patients with heart failure with reduced ejection fraction: a meta-analysis of the EMPEROR-Reduced and DAPA-HF trials. The Lancet. 2020;396(10254):819–29. DOI: 10.1016/S0140-6736(20)31824-9

109. Oates CP, Santos‐Gallego CG, Smith A, Basyal B, Moss N, Kawamura I et al. SGLT2 inhibitors reduce sudden cardiac death risk in heart failure: Meta‐analysis of randomized clinical trials. Journal of Cardiovascular Electrophysiology. 2023;34(5):1277–85. DOI: 10.1111/jce.15894

110. Xiang B, Zhang R, Wu X, Zhou X. Optimal Pharmacologic Treatment of Heart Failure With Preserved and Mildly Reduced Ejection Fraction: A Meta-analysis. JAMA Network Open. 2022;5(9):e2231963. DOI: 10.1001/jamanetworkopen.2022.31963

111. Tang J, Wang P, Liu C, Peng J, Liu Y, Ma Q. Pharmacotherapy in patients with heart failure with reduced ejection fraction: A systematic review and meta-analysis. Chinese Medical Journal. 2024; [Ahead of print]. DOI: 10.1097/CM9.0000000000003118

112. Fox K, Ford I, Steg PG, Tendera M, Ferrari R. Ivabradine for patients with stable coronary artery disease and left-ventricular systolic dysfunction (BEAUTIFUL): a randomised, double-blind, placebo-controlled trial. The Lancet. 2008;372(9641):807–16. DOI: 10.1016/S0140-6736(08)61170-8

113. Swedberg K, Komajda M, Böhm M, Borer JS, Ford I, Dubost-Brama A et al. Ivabradine and outcomes in chronic heart failure (SHIFT): a randomised placebo-controlled study. The Lancet. 2010;376(9744):875–85. DOI: 10.1016/S0140-6736(10)61198-1

114. Rathore SS, Wang Y, Krumholz HM. Sex-Based Differences in the Effect of Digoxin for the Treatment of Heart Failure. New England Journal of Medicine. 2002;347(18):1403–11. DOI: 10.1056/NEJMoa021266

115. Adams KF, Patterson JH, Gattis WA, O’Connor CM, Lee CR, Schwartz TA et al. Relationship of Serum Digoxin Concentration to Mortality and Morbidity in Women in the Digitalis Investigation Group Trial. Journal of the American College of Cardiology. 2005;46(3):497–504. DOI: 10.1016/j.jacc.2005.02.091

116. Rathore SS, Curtis JP, Wang Y, Bristow MR, Krumholz HM. Association of serum digoxin concentration and outcomes in patients with heart failure. JAMA. 2003;289(7):871–8. DOI: 10.1001/jama.289.7.871

117. Ahmed A, Rich MW, Fleg JL, Zile MR, Young JB, Kitzman DW et al. Effects of Digoxin on Morbidity and Mortality in Diastolic Heart Failure: The Ancillary Digitalis Investigation Group Trial. Circulation. 2006;114(5):397–403. DOI: 10.1161/CIRCULATIONAHA.106.628347

118. Sica DA, Wood M, Hess M. Gender and Its Effect in Cardiovascular Pharmacotherapeutics: Recent Considerations. Congestive Heart Failure. 2005;11(3):163–6. DOI: 10.1111/j.1527-5299.2005.04171.x

119. Ahmed A, Pitt B, Rahimtoola SH, Waagstein F, White M, Love TE et al. Effects of digoxin at low serum concentrations on mortality and hospitalization in heart failure: A propensity-matched study of the DIG trial. International Journal of Cardiology. 2008;123(2):138–46. DOI: 10.1016/j.ijcard.2006.12.001

120. Celik A, Sahin A, Ata N, Colluoglu IT, Ural D, Kanik EA et al. Navigating Heart Failure: Unveiling Sex Disparities in Guideline-Directed Medical Therapy Combinations. The American Journal of Cardiology. 2024;216:27–34. DOI: 10.1016/j.amjcard.2024.01.017

121. Ouyang A-J, Lv Y-N, Zhong H-L, Wen J-H, Wei X-H, Peng H-W et al. Meta-Analysis of Digoxin Use and Risk of Mortality in Patients With Atrial Fibrillation. The American Journal of Cardiology. 2015;115(7):901–6. DOI: 10.1016/j.amjcard.2015.01.013

122. Vamos M, Erath JW, Hohnloser SH. Digoxin-associated mortality: a systematic review and meta-analysis of the literature. European Heart Journal. 2015;36(28):1831–8. DOI: 10.1093/eurheartj/ehv143

123. Ziff OJ, Lane DA, Samra M, Griffith M, Kirchhof P, Lip GYH et al. Safety and efficacy of digoxin: systematic review and meta-analysis of observational and controlled trial data. BMJ. 2015;351:h4451. DOI: 10.1136/bmj.h4451

124. Bavishi C, Khan AR, Ather S. Digoxin in patients with atrial fibrillation and heart failure: A meta-analysis. International Journal of Cardiology. 2015;188:99–101. DOI: 10.1016/j.ijcard.2015.04.031

125. Dries DL, Rosenberg YD, Waclawiw MA, Domanski MJ. Ejection Fraction and Risk of Thromboembolic Events in Patients With Systolic Dysfunction and Sinus Rhythm: Evidence for Gender Differences in the Studies of Left Ventricular Dysfunction Trials. Journal of the American College of Cardiology. 1997;29(5):1074–80. DOI: 10.1016/S0735-1097(97)00019-3

126. Homma S, Thompson JLP, Pullicino PM, Levin B, Freudenberger RS, Teerlink JR et al. Warfarin and aspirin in patients with heart failure and sinus rhythm. New England Journal of Medicine. 2012;366(20):1859–69. DOI: 10.1056/NEJMoa1202299

127. Mehra MR, Vaduganathan M, Fu M, Ferreira JP, Anker SD, Cleland JGF et al. A comprehensive analysis of the effects of rivaroxaban on stroke or transient ischaemic attack in patients with heart failure, coronary artery disease, and sinus rhythm: the COMMANDER HF trial. European Heart Journal. 2019;40(44):3593–602. DOI: 10.1093/eurheartj/ehz427

128. Beggs SAS, Rørth R, Gardner RS, McMurray JJV. Anticoagulation therapy in heart failure and sinus rhythm: a systematic review and meta-analysis. Heart. 2019;105(17):1325–34. DOI: 10.1136/heartjnl-2018-314381

129. Xie S, Chen J, Xiong G, Li J, Wan J, Liu Y et al. The efficacy and safety of rivaroxaban in coronary artery disease patients with heart failure and sinus rhythm: a systematic review and meta-analysis. European Journal of Clinical Pharmacology. 2021;77(10):1485–94. DOI: 10.1007/s00228-021-03195-w

130. Мареев В.Ю., Беграмбекова Ю.Л., Мареев Ю.В., Кобалава Ж.Д., Карапетян Л.В., Галочкин С.А. и др. Распространенность дефицита железа у пациентов с хронической сердечной недостаточностью в Российской Федерации. Данные наблюдательного одномоментного исследования. Кардиология. 2022;62(5):4-8. DOI: 10.18087/cardio.2022.5.n2083

131. Беграмбекова Ю.Л., Мареев Ю.В., Мареев В.Ю., Орлова Я.А., Кобалава Ж.Д., Карапетян Л.В. и др. Женский и мужской фенотипы дефицита железа при ХСН. Дополнительный анализ исследования ‘Распространенность дефицита железа у пациентов с хронической сердечной недостаточностью в российской федерации (ДЖ-ХСН-РФ)’. Кардиология. 2023;63(9):3-13. DOI: 10.18087/cardio.2023.9.n2413

132. McCullough PA, Barnard D, Clare R, Ellis SJ, Fleg JL, Fonarow GC et al. Anemia and Associated Clinical Outcomes in Patients With Heart Failure Due to Reduced Left Ventricular Systolic Function. Clinical Cardiology. 2013;36(10):611–20. DOI: 10.1002/clc.22181

133. Kajimoto K, Minami Y, Sato N, Otsubo S, Kasanuki H. Gender Differences in Anemia and Survival in Patients Hospitalized for Acute Decompensated Heart Failure With Preserved or Reduced Ejection Fraction. The American Journal of Cardiology. 2017;120(3):435–42. DOI: 10.1016/j.amjcard.2017.04.043

134. Anker SD, Khan MS, Butler J, Von Haehling S, Jankowska EA, Ponikowski P et al. Effect of intravenous iron replacement on recurrent heart failure hospitalizations and cardiovascular mortality in patients with heart failure and iron deficiency: A Bayesian meta‐analysis. European Journal of Heart Failure. 2023;25(7):1080–90. DOI: 10.1002/ejhf.2860

135. Ponikowski P, Mentz RJ, Hernandez AF, Butler J, Khan MS, Van Veldhuisen DJ et al. Efficacy of Ferric carboxymaltose in heart failure with iron deficiency: an individual patient data meta-analysis. European Heart Journal. 2023;44(48):5077–91. DOI: 10.1093/eurheartj/ehad586

136. Lam CSP, Piña IL, Zheng Y, Bonderman D, Pouleur A-C, Saldarriaga C et al. Age, Sex, and Outcomes in Heart Failure With Reduced EF: Insights From the VICTORIA Trial. JACC: Heart Failure. 2023;11(9):1246–57. DOI: 10.1016/j.jchf.2023.06.020

137. Bauersachs J, Arrigo M, Hilfiker-Kleiner D, Veltmann C, Coats AJS, Crespo-Leiro MG et al. Current management of patients with severe acute peripartum cardiomyopathy: practical guidance from the Heart Failure Association of the European Society of Cardiology Study Group on peripartum cardiomyopathy. European Journal of Heart Failure. 2016;18(9):1096–105. DOI: 10.1002/ejhf.586

138. Arany Z. Peripartum Cardiomyopathy. New England Journal of Medicine. 2024;390(2):154–64. DOI: 10.1056/NEJMra2306667 139. Regitz-Zagrosek V, Roos-Hesselink JW, Bauersachs J, Blomström-Lundqvist C, Cífková R, De Bonis M et al. 2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy. European Heart Journal. 2018;39(34):3165–241. DOI: 10.1093/eurheartj/ehy340