简介：Wolff-Parkinson-White(WPW)syndromeisacongenitaldisorderofcardiacconductionsystemcharacterizedbyelectrocardiographicpreexcitationandepisodesofparoxysmalsupraventriculartachycardia.Itiscausedbyacardiacdevelopmentaldefectintheelectricalinsulationbetweentheatriaandtheventriclesduetothepresenceofanaccessorypathway.WPWsyndromeisacommoncauseofsupraventriculartachycardiawithbenignprognosis.However,thisclinicalentityalsopredisposespatientstoanincreasedriskofsuddencardiacdeath,especiallyinthesettingofpreexcitedatrialfibrillation.WPWsyndromeisusuallysporadicandofunknownetiologyinmostcases.Duringthepast10years,asignificantheritablefactorisincreasinglyrecognized.IdentificationofthegeneticbasisamongpatientswithWPWsyndromehasimportantimplicationsforunderstandingthemolecularmechanismofventricularpreexcitationandthedevelopmentoftherapeuticstrategiesforriskstratificationandmanagement.Thegoalofthisreviewistoexaminethepreviousstudiesonhereditaryvariants,aswellastooutlinepotentialfutureavenuestowarddefiningtheheritabilityofWPWsyndrome.

简介：ObstructiveSleepApnea(OSA)isacommonchronicdisorderthataffects5–10%oftheUSpopulationwithahigherprevalenceinmencomparedtowomenby2:1inpopulationstudies.Bycontrast,inpatientswithcardiovasculardisease,itsprevalencecanexceed50%dependingonthespecificdisordersurveyed.Althoughsexdifferenceshavebeenwelldescribedforcardiovascularriskfactors;existingdataregardingtheimpactofsexontherelationshipbetweenOSAandcardiovascularoutcomesiscontroversial.Similarly,whilethereisstrongevidenceforincreasedprevalenceofcardiovascularconditions,suchassystemichypertension,atrialfibrillation,aswellasheartfailureamongstpatientssufferingfromOSA;conflictingevidenceexistsregardingtheincidenceandbidirectionalrelationshipbetweenthemaswellastheimpactoftreatmentofOSAoncardiovascularoutcomes.Inthispaper,wewillreviewtheassociationsbetweenOSAandcardiovasculardiseasesinwomen.Thedataonsexdifferencesislimited,duetoanumberofreasons,including,butnotlimitedtolatepresentationofOSAinwomen,difficultiesindiagnosingbothOSAandcardiovasculardiseasesinwomenandstillsuboptimalinclusionofadequatenumberofwomeninclinicaltrials.MorestudiesareneededtobetterdelineatesexdifferencesintheclinicalpresentationaswellasthepathophysiologyoftheassociationsbetweenOSAandcardiovasculardiseasessothatwecanprovidepatientswithmorepersonalizedcare.

简介：Depression/anxiety-relateddisordersandpsychosocialstresshavebeenimplicatedascardiovasculardisease(CVD)riskfactors.Womenareatconsiderableriskforaffectivedisordersandreportgreaterseverityfrompsychosocialstress,comparedtomen.Affectivedisordersandcardiovasculardiseaselikelyshareunderlyingpathophysiologicalmechanismsthatarepotentiatedamongwomen–especiallyyoungerwomen.Environmentalstressorsthatthreatenthesafety,security,andstatusofanindividualareappraisedbythebrain,producingacascadeofevokedphysiologicalandcognitiveresponses.Intheshortterm,theseprocessesovercomestressors,butcomewithlong-termhealthimplications.Chronicpsychosocialstressleadstoadysregulationofthestressresponsesystemsthatcanleadtoaheightenedstressappraisalschemacalledtheunpredictabilityschema,aconstructthatmightarguablyplacewomenatheightenedriskforCVD.

简介：Peripartumcardiomyopathy(PPCM)isadisorderinwhichheartfailuredevelopsinthelastmonthofpregnancyorwithinthefirstfivemonthspostpartum.Theexactetiologyisnotknownalthoughrecentstudiessuggestangiogenicimbalanceisakeyfactorwithsolublefms-liketyrosinekinase-1(sFlt1)andacleavedformofprolactinpossiblyplayingimportantroles.Thisreviewdiscussestheepidemiology,riskfactors,diagnosis,treatmentandprognosisofPPCMandhighlightsrecentadvancesinourunderstandingofthisdisorder.

简介：Conventionalrecommendationsfordiagnostictestingfortheevaluationofstableischemicheartdiseaseinwomenhavelargelyparalleledthoseinmen.Althoughtheyaredesignedprimarilyfortheidentificationofobstructivecoronaryarterydisease(CAD),traditionalapproachescanleadtoovertestinginwomenwithoutdifferentiatingwhoistrulyatrisk.Severaluniquefactorsrelatedtothepresentation,diagnosis,andunderlyingpathophysiologyofstableischemicheartdiseaseinwomennecessitateamorespecificapproachtotheassessmentoftheirrisk,completewithseparateguidelineswhenappropriate.Thisoverviewhighlightshowadvancednoninvasiveimagingtools,includingcardiaccomputedtomographyangiography,positronemissiontomography,andcardiacmagneticresonanceimaging,areenablingverysensitiveassessmentsofanatomicatheroscleroticplaqueburden,macrovessel-andmicrovessel-relatedischemia,andmyocardialfibrosis,respectively.Movingforward,effectivediagnostictestingwillneedtoidentifywomenathighriskofadversecardiovascularevents(notanatomicallyobstructiveCADperse)withoutovertestingthoseatlowrisk.JudiciousapplicationofnovelimagingapproacheswillbecriticaltobroadeningthedefinitionsofCADandischemiatobetterreflectthewholespectrumofpathologicalphenotypesinwomen,includingnonobstructiveCADandcoronarymicrovasculardysfunction,andaidinthedevelopmentofneededevidence-basedstrategiesfortheirmanagement.

简介：Sex-specificdifferencesintheepidemiologyandpathophysiologyofcoronaryarterydiseaseandischemicheartdiseasearenowwellrecognized.Womenwithanginamoreoftenhavenonobstructivecoronaryarterydisease(NOCAD)comparedwithmen.Thispatientpopulationcarriesasignificantriskoffuturecardiovasculareventsthatisnotcommonlyappreciated,oftenleadingtodelayeddiagnosisandtreatment.WhilecoronarymicrovasculardysfunctionplaysacentralroleinthepathophysiologyofNOCADinwomen,othermechanismsofmyocardialischemiaarenowrecognized.RiskfactorssuchashypertensionandobesitydisparatelyaffectwomenandarelikelytoaccountforasignificantproportionofNOCADinthecomingyears.VascularinflammationisanimportantpathophysiologicpathwayinNOCADandisapotentialtherapeutictarget.CoronaryCTangiographyprovidesacomprehensiveassessmentofcoronaryanatomyandplaquemorphologyandisareasonablescreeningtestofchoiceforNOCAD.

简介：APeruviannative,Dr.VelardeearnedhermedicaldegreefromtheNewYorkUniversitySchoolofMedicineinNewYorkandwentontocompleteherresidencytraininginInternalMedicineatColumbiaPresbyterianMedicalCenterandCardiovascularDiseasefellowshiptrainingatMountSinaiHospitalinNewYorkandBostonUniversity.Dr.GladysP.VelardeisAssociateProfessorofMedicine/CardiologyatTheUniversityofFlorida,JacksonvillewhereshedirectstheWomen’sCardiovascularHealthProgramandisDirectoroftheCardiovascularDiseaseFellowshiptrainingprogram.