Mechanisms of sex differences in atrial fibrillation: role of hormones and differences in electrophysiology, structure, function, and remodelling
File(s)
Author(s)
Type
Journal Article
Abstract
Atrial fibrillation (AF) is the clinically most prevalent rhythm disorder with large impact on quality of life and increased risk for hospitalizations and mortality in both men and women. In recent years, knowledge regarding epidemiology, risk factors, and patho-physiological mechanisms of AF has greatly increased. Sex differences have been identified in the prevalence, clinical presentation, associated comorbidities, and therapy outcomes of AF. Although it is known that age-related prevalence of AF is lower in women than in men, women have worse and often atypical symptoms and worse quality of life as well as a higher risk for adverse events such as stroke and death associated with AF. In this review, we evaluate what is known about sex differences in AF mechanisms-covering structural, electrophysiological, and hormonal factors-and underscore areas of knowledge gaps for future studies. Increasing our understanding of mechanisms accounting for these sex differences in AF is important both for prognostic purposes and the optimization of (targeted, mechanism-based, and sex-specific) therapeutic approaches.
Date Issued
2019-03-01
Date Acceptance
2018-09-03
Citation
EP-Europace, 2019, 21 (3), pp.366-376
ISSN
1099-5129
Publisher
Oxford University Press (OUP)
Start Page
366
End Page
376
Journal / Book Title
EP-Europace
Volume
21
Issue
3
Copyright Statement
© The Author(s) 2018. Published on behalf of the European Society of Cardiology. All rights reserved. For permissions, please email: journals.permissions@oup.com. This is a pre-copy-editing, author-produced version of an article accepted for publication in EP-Europace following peer review. The definitive publisher-authenticated version is available online at: https://dx.doi.org/10.1093/europace/euy215
Sponsor
British Heart Foundation
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/30351414
PII: 5142404
Grant Number
RG/16/3/32175
Subjects
Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Cardiovascular System & Cardiology
Atrial fibrillation
Sex differences
Mechanisms
Electrophysiology
Structural remodelling
Sex hormones
Estrogen
GENDER-RELATED DIFFERENCES
EPICARDIAL ADIPOSE-TISSUE
HEART-RATE-VARIABILITY
PHYSICAL-ACTIVITY
QT-INTERVAL
DIASTOLIC DYSFUNCTION
FAMILIAL AGGREGATION
GENOMIC REGULATION
CATHETER ABLATION
POTASSIUM CHANNEL
Atrial fibrillation
Electrophysiology
Estrogen
Mechanisms
Sex differences
Sex hormones
Structural remodelling
Cardiovascular System & Hematology
1103 Clinical Sciences
Publication Status
Published
Coverage Spatial
England
Article Number
ARTN euy215
Date Publish Online
2018-10-22