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Impact of Sex and Diabetes in Patients with Heart Failure

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Abstract

Purpose of review

Heart failure (HF) is a complex clinical syndrome with a growing global health burden. This review explores the intersection of HF, diabetes mellitus, and sex, highlighting epidemiological patterns, pathophysiological mechanisms, and treatment implications.

Recent findings

Despite similar HF prevalence in men and women, diabetes mellitus (DM) appears to exert a more pronounced impact on HF outcomes in women. Pathophysiological differences involve cardiovascular risk factors, severe left ventricular dysfunction, and coronary artery disease, as well as hormonal influences and inflammatory markers. Diabetic cardiomyopathy introduces a sex-specific challenge, with women experiencing common adverse outcomes related to increased fibrosis and myocardial remodeling. Treatment strategies, particularly sodium-glucose cotransporter 2 inhibitors, exhibit cardiovascular benefits, but their response may differ in women.

Summary

The link between HF and DM is bidirectional, with diabetes significantly increasing the risk of HF, and vice versa. Additionally, the impact of diabetes on mortality appears more pronounced in women than in men, leading to a modification of the traditional gender gap observed in HF outcomes. A personalized approach is crucial, and further research to improve outcomes in the complex interplay of HF, diabetes, and sex is needed.

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Data availability

The data analyzed during the writing of this review article are derived from publicly available articles, all of which are freely accessible in their respective journals or repositories. No additional data were generated or used in this review. The references for each article are provided within the text for further inquiry.

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  1. Cardiology Department, Hospital General Universitario Gregorio Marañón, Calle Doctor Esquerdo, 46, 28007, Madrid, Spain

    Sara Álvarez-Zaballos & Manuel Martínez-Sellés

  2. Universidad Europea, Universidad Complutense, Madrid, Spain

    Manuel Martínez-Sellés

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MMS had the idea for the article. SAZ performed the literature research and data analysis. SAZ wrote the first draft. All authors performed the revision of the article.

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Correspondence to Manuel Martínez-Sellés.

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Álvarez-Zaballos, S., Martínez-Sellés, M. Impact of Sex and Diabetes in Patients with Heart Failure. Curr Heart Fail Rep (2024). https://doi.org/10.1007/s11897-024-00666-w

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