Current Heart Failure Reports

, Volume 9, Issue 4, pp 267–276 | Cite as

Gender Differences in the Pathophysiology, Clinical Presentation, and Outcomes of Ischemic Heart Failure

  • Shannon M. Dunlay
  • Véronique L. RogerEmail author
Prevention of Heart Failure After Myocardial Infarction (M St. John Sutton, Section Editor)


Despite advances in the treatment of acute myocardial infarction (MI), heart failure (HF) remains a frequent acute and long-term outcome of ischemic heart disease (IHD). In response to acute coronary ischemia, women are relatively protected from apoptosis, and experience less adverse cardiac remodeling than men, frequently resulting in preservation of left ventricular size and ejection fraction. Despite these advantages, women are at increased risk for HF- complicating acute MI when compared with men. However, women with HF retain a survival advantage over men with HF, including a decreased risk of sudden death. Sex-specific treatment of HF has been hindered by historical under-representation of women in clinical trials, though recent work has suggested that women may have a differential response to some therapies such as cardiac resynchronization. This review highlights the sex differences in the pathophysiology, clinical presentation and outcomes of ischemic heart failure and discusses key areas worthy of further investigation.


Women Gender Coronary disease Heart failure Myocardial infarction Ischemic heart disease Disparities 



We would like to thank David Cheney for creating the medical illustration used in the Figure.


No potential conflicts of interest relevant to this article were reported.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Division of Cardiovascular Diseases in the Department of MedicineMayo ClinicRochesterUSA
  2. 2.Department of Health Sciences ResearchMayo ClinicRochesterUSA

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