摘要
背景心失败(HF ) 是为变老的人口的一个增加的问题，明确地在女人之中。HF 的病原学影响治疗的选择和结果。在不同研究在在病态和死亡的性之间有变化，可能思考的病原学。这研究的目的是在长期的心失败的病原学检验为性差别可得到的证据的力量。为在心失败的病原学的性差别的从 1980 ～ 2009 的方法帮助计算机的搜索被执行(Medline， EMBASE 和 PubMed ) 。从基于包括标准考察的 2347 篇摘要， 35 篇原来的文章为评论被选择。数据抽取基于观察研究(未来 / 回顾的队或十字部分) 与一个平均数列在后面在上面 3 个月。在数据抽取上的 2 个评论家之间没有 interrater 可变性。结果是更多与男性别联系了的室的收缩机能障碍，而是女性别是报导与保存左室的功能被联系的更多。Ischemic 病原学和联系的冠的心疾病强烈与男性别被相关。为 HF 的风险是戏剧性地，更多与收缩高血压为女人提高了，但是糖尿病 mellitus 的协会在男性和女性之间作为 HF 的病原学是有点相等的。在在心血管的疾病关于性差别得出结论的限制之一是许多主要临床的试用不包括性分析也不他们是动力的那么作为女人做的结论在大多数 HF 研究是未被充分代表的。需要基于性差别有或没有心失败和分析病原学和风险因素为男、女的病人的足够的数字的很好设计的未来的研究留下。
Background Heart failure （HF） is an increasing problem for the aging population, specifically among women. The etiology of HF influences both the selection and outcome of the treatment. There are variations between genders in morbidity and mortality in different studies, possibly reflecting etiology. The objective of this study was to examine the strength of evidence available for gender differences in the etiology of chronic heart failure. Methods Computer-assisted searches from 1980-2009 for gender differences in the etiology of heart failure were performed （Medline, EMBASE and PubMed）. From 2347 abstracts reviewed based on inclusion criteria, 35 original articles were chosen for review. Data extraction was based on observational studies （prospective/retrospective cohort or cross sectional） with a mean follow up of 3 months. There was no interrater variability between the 2 reviewers on data-extraction. Results Ventricular systolic dysfunction being more associated with male sex, but female sex was more reported to be associated with preserved left ventricular function. Ischemic etiology and associated coronary heart disease were strongly correlated with male sex. The risk for HF was dramatically more elevated for women with systolic hypertension but the association for diabetes mellitus as the etiology of HF was somewhat equal between males and females. Conclusions One of the limitations in reaching conclusions about gender differences in cardiovascular disease is that many major clinical trials do not include a gender analysis nor they are powered to do so as women are under-represented in most of the HF studies. The need remains for a well designed prospective study of sufficient numbers of male and female patients with and without heart failure and analyzing etiology and risk factors based on the sex differences.
