Abstract
Evidence from several observational studies suggests sex-related differences in the incidence and prognosis of CHF. The main objective of the study is to report clinical, electrical, echocardiographic, etiological and therapeutic aspects of CHF in women. It is a transversal retrospective study conducted between May 2006 and June 2019 including all patients beyond the age of 14 with congestive heart failure followed-up in the therapeutic unit of heart failure of our department. We studied clinical, electrical, echocardiographic and etiological aspects of CHF among women compared to men. Among 3412 CHF patients: 1237 were women (36.25%), women mean age was 64.96 ± 12.96 years vs. 64.89 ± 12.79 years in men ( P = 0,068). A total of 37.8% of women were diabetic vs. 26,1% of men ( P < 0.001), 49.6% were hypertensive vs. 32.7% ( P < 0.001), 4% were smokers vs. 42.5% ( P < 0.001), 12.3%vs 8.4% were dyslipidemic ( P = 0.002). 25.8% had a history of myocardial infarctionvs 32.6%. CHF in women compared to men was due to ischemic heart disease in 50.6% vs. 63.2%, dilated cardiomyopathy in 13% vs. 8.8%, valvular heart disease in 4.4%vs 3.3%, cardiac toxicity in 3.5%vs 0,8%, peripartum cardiomyopathy in 0,8% ( P < 0.001). Dyspnea in women compared to men was classified mostly class II NYHA in 59.7% vs. 57.3%, class III in 22%vs 17,9%, class IV in 1,9%vs 2%. Mean heart rate was 79.06 ± 16.65 bpm and mean blood pressure was 131.51 ± 24,89/75,27 ± 13,69 mmHg. 12,8% of women had atrial fibrillation vs. 12.5% in men ( P = 0.860). Mean LVEF was 37.43 ± 15.85% vs. 35.65 ± 10.07% in men P < 0.001. No impact of gender on hospitalization for HF was observed ( P = 0.867) Several clinical and epidemiological studies, in particular the Framingham and MILIS trials, indicate an increased long-term risk of CHF following myocardial infarction in women. This may be explained by a greater prevalence of risk factors for coronary atherosclerosis as well as by female gender.
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