Abstract
Heart failure (HF) poses a heavy burden on patients, their families and society. The syndrome of HF comes in two types: with reduced ejection fraction (HFrEF) and preserved ejection fraction (HFpEF). The latter is on the increase and predominantly present in women, especially the older ones. There is an urgent need for mortality-reducing drugs in HFpEF, a disease affecting around 5 % of those aged 65 years and over. HFpEF develops in patients with risk factors and comorbidities such as obesity, hypertension, diabetes, COPD, but also preeclampsia. These conditions are likely to drive microvascular disease with involvement of the coronary microvasculature, which may eventually evolve into HFpEF. Currently, the diagnosis of HFPEF relies mainly on echocardiography. There are no biomarkers that can help diagnose female microvascular disease or facilitate the diagnosis of (early stages of) HFpEF. Recently a Dutch consortium was initiated, Queen of Hearts, with support from the Netherlands Heart Foundation, with the aim to discover and validate biomarkers for diastolic dysfunction and HFpEF in women. These biomarkers come from innovative blood-derived sources such as extracellular vesicles and circulating cells. Within the Queen of Hearts consortium, we will pursue female biomarkers that have the potential for further evolution in assays with point of care capabilities. As a spin-off, the consortium will gain knowledge on gender-specific pathology of HFpEF, possibly opening up novel treatment options.
Highlights
Heart failure (HF) poses a heavy burden on patients, their families and society
HF and a preserved ejection fraction (HFpEF) is associated with diastolic left ventricular dysfunction that involves reduced left ventricular relaxation and increased left ventricular stiffness with a relatively normal ejection fraction of 50 % or more [6]
The Queen of Hearts program hypothesises that comorbidities such as diabetes, chronic obstructive pulmonary disease (COPD), and preeclampsia share a common pathway to the development of HFpEF from which gender-specific biomarkers in women can be deduced
Summary
Cardiovascular disease (CVD) is the number one killer among women worldwide. Controversially, women have been underrepresented in most clinical trials on cardiovascular disease. Screening studies showed that unrecognised HF is common in high-risk groups such as older community-dwelling individuals with chronic obstructive pulmonary disease (COPD) and diabetes type 2, with prevalence rates of undetected HF of 20.5 and 27.7 %, respectively [8, 9]. In those with COPD aged 65 years and over and novel screen-detected heart failure, 50 % had HFpEF. The prevalence of unrecognised HFpEF in patients with type 2 diabetes was much higher in women than in men (28.0 vs 18.4 %), and this was in all age strata [9]. The prevalence of unknown HFpEF in patients with type 2 diabetes and aged 60 years or over was clearly higher in women than men [9]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
