Biology of Women’s Heart Health (Advances in Biochemistry in Health and Disease, 26)

Contents
1 The Emerging Need for Research on Women’s Heart Health
	The History of woman’s Health Research
	The Need for Woman’s Heart Health Research
	Understanding the Risk Factors for Cardiovascular Disease in Women
	Future Directions
	Conclusions
	References
2 Risk Factors for Ischemic Stroke in Women
	Epidemiology
	Sex-Specific Risk Factors for Ischemic Stroke
		Pregnancy or the Puerperium Period
		Sex-Specific Risk Factors Outside of Pregnancy or Puerperium
	Sex Differences in Risk Factors Shared by Men and Women
		Traditional Vascular Risk Factors
		Sex and Heart-Brain Interactions
		Beyond Traditional Vascular Risk Factors
	Clinical Implications and Future Research
	Summary
	References
3 The Effects of Sex Steroid Hormones on Cardiovascular Physiology in Females
	Estrogen Synthesis and Classification
	Genomic and Non-Genomic Effects of Estrogen
	Estrogens and the Cardiovascular System
	The Role of Estrogen in Oxidative Stress, Inflammation and Endothelial Function
	The Role of Estrogen in Lipid Profile Alterations, Obesity and Atherosclerosis
	Hormone Replacement Studies and the Timing Hypothesis
	The Influence of Estrogen on Endothelial Adaptations to Endurance Training
	Progesterone
	Testosterone
	Conclusion
	References
4 Spontaneous Coronary Artery Dissection (SCAD): An Overview of the Condition, Diagnostic Work Up and Management
	Introduction
	Definition and Classification of SCAD
	Pathophysiology of SCAD
	Epidemiology of SCAD
	Risk Factors for SCAD
	Clinical Presentation of SCAD
	What to Do if You Suspect Your Patient Has SCAD
	Conservative Versus Invasive Management
	Medical Management
	Outpatient Management of SCAD Patients
	Cardiac Rehabilitation
		Cardiac Rehabilitation and SCAD Patients
		Physical Activity After SCAD
	Future Directions and Opportunities
	References
5 Takotsubo Cardiomyopathy
	Introduction
	Definition and Diagnostic Criteria
	Epidemiology and Predisposing Factors
	Pathophysiology
	Clinical Presentation and Diagnostic Work Up
	In Hospital Risk Stratification and Complications
	Long Term Prognosis and Follow up
	Conclusion
	References
6 Preeclampsia: Early and Long-Term Clinical Considerations
	Introduction
	Overview
		Diagnosis of Preeclampsia
		Pathophysiology of Preeclampsia:
		Outcomes and Burden of Preeclampsia:
		Risk Factors and Primary Prevention of Preeclampsia:
	Antepartum Management of Preeclampsia
		Screening for the Development of Preeclampsia
		Clinical Presentation of Preeclampsia and Assessment of Complications
		Antepartum Management of Preeclampsia:
		Management During Delivery
		Management and Prevention of Eclampsia:
	Post-partum Diagnosis and Management of Preeclampsia
		Diagnosis of Post-partum Preeclampsia
		Recurrence and Secondary Prevention
		Lifelong Cardiovascular Risk and Outcomes
		Factors Associated with Lifelong Risk
		Screening for the Development of Cardiovascular Disease
		Long Term Pharmacologic Management:
	Statins
	Acetylsalicylic Acid and Angiotensin Converting Enzyme Inhibitors
	Summary
	References
7 Myocardial Infarction with Non-obstructive Coronary Artery Disease: An Overview of Definition, Classification, Diagnostic Workup and Management
	Introduction
	Definition
	Epidemiology
	Diagnostics
	Pathophysiologic Mechanisms
		Atherosclerotic
		Nonatherosclerotic
	Prognosis
	Conclusion
	Case Examples
	References
8 Blood Pressure: Changes Over a Woman’s Life, the Effect of Estrogen, and Special Considerations in Women
	Introduction
	Blood Pressure Effects of Endogenous Estrogens and Progesterone
	Hypertension in Girls and Adolescent Women
	Hypertension in Women of Reproductive Age
	Oral Contraceptives and Hypertension
	Polycystic Ovary Syndrome and Hypertension
	Hypertensive Disorders in Pregnancy
	Hypertension and Menopausal Hormone Therapy
	Sex-Specific Differences in Clinical Trials and Differences in Treating Hypertension in Women
	Future Directions and Unanswered Questions
	Conclusion
	References
9 Gestational Diabetes as a Risk Factor for Cardiovascular Disease
	Gestational Diabetes
		Definitions and Epidemiology
		Pathophysiology of Gestational Diabetes
		Gestational Diabetes Diagnosis and Risk Factors
		Complications of Gestational Diabetes
	Pathogenesis of Gestational Diabetes as a Risk Factor for Cardiovascular Disease
		Risk of Type 2 Diabetes
		Shared Risk Factors
		Other Mechanisms
	Epidemiology
	Cardiovascular Disease Risk Factors
	Postpartum Screening
	Preventing Cardiovascular Disease Following Gestational Diabetes
		Preventing or Delaying Type 2 Diabetes Following Gestational Diabetes
		Treating Cardiovascular Disease Risk Factors—Postpartum Considerations
		Safe Effective Contraception
	Future Directions
	References
10 Menopause and the Bridge to Cardiovascular Disease
	Introduction
	Setting the Stage: Defining Key Elements of Menopause
	Emergence of Risk
	Hormone Replacement Therapy (HRT): Restoring the “Protection”?
	Women’s Health Education
	Path Forward
	References
11 Vascular Dysfunction in Women
	Introduction
	Arterial Stiffness and Cardiovascular Disease Risk
	Sex-Specific Factors Contributing to Vascular Stiffness
		Sex Hormones Affecting Vascular Stiffness
		Post-menopause, Hormone Replacement Therapies and Oral Contraceptives
		Aging and Vascular Stiffness
		Lifestyle (Exercise and Diet)
		Pregnancy and Preeclampsia
		Psychosocial Stresses
	Conclusion and Future Directions
	References
12 Cardiometabolic Function in Women
	Introduction
	Gender Differences in Cardiovascular (CV) Risk Factors Between Men and Women
	The Mechanistic Basis of Gender-Specific Contributors for CMD Development
	Cardiometabolic Aspects in Women
		Hypertension in Women
	Sex Specific Factors that Influence Hypertension
		Hypertension and Menopause
	Hypertension and Oral Contraceptive Pills Usage
	Hypertension and Pregnancy
	Hypertension and PCOS
	Insulin Resistance and Diabetes Mellitus in Women
	Insulin Resistance, Diabetes Mellitus and Women-Specific Factors
		Insulin Resistance, Diabetes Mellitus and Menopause
	Insulin Resistance, Diabetes Mellitus and Pregnancy
	Insulin Resistance, Diabetes Mellitus and PCOS
	Obesity in Women
	Obesity and Women-Specific Factors
		Obesity and Menopause
	Obesity and Pregnancy
	Obesity and PCOS
	Dyslipidemia in Women
	Dyslipidemia and Women-Specific Factors
		Dyslipidemia and Pregnancy
	Dyslipidemia and Menopause
	Dyslipidemia and PCOS
	Conclusion
	References
13 Molecular Basis of the Circadian Mechanism in Women
	Overview of Circadian Rhythm
	Consequences of Circadian Misalignment in the Female Sex
	Potential Therapeutics and Conclusions
	References
14 Cardio-Rheumatology and Women’s Hearts
	Cardiovascular Manifestations of Rheumatic Diseases
	ASCVD Risk Assessment
	Select Conditions Disproportionately Affecting Women
		Rheumatoid Arthritis (RA)
		Systemic Lupus Erythematosus (SLE)
		Systemic Sclerosis (SSc)
		Giant Cell Arteritis (GCA)
		Takayasu Arteritis (TA)
		Osteoarthritis (OA)
	Other Important Considerations
		Ethnicity
		Reproductive Health Issues
		Societal Stigma
	Future Directions
	References
15 Cardiovascular Adverse Effects of Breast Cancer Chemotherapy
	Cardiovascular Complications of Chemotherapies
	Known Mechanisms of Doxorubicin-Induced Cardiotoxicity
		Doxorubicin Interacts with DNA and Topoisomerase II
		Doxorubicin Increases Cellular Oxidative Stress
		Doxorubicin Induces Cell Death Pathways
	Prediction and Prevention of Doxorubicin-Induced Cardiotoxicity
		Current Preventive Strategies for Doxorubicin-Induced Cardiotoxicity
		Advances in Approaches for Cardiovascular Research
		Pharmacogenomics and Precision Medicine
	Conclusion
	References
16 Sex-Dependent Differences in the Diagnosis, Treatment and Causes of Heart Failure
	Introduction
	History
	HFpEF
	Current Treatments
	Female-Specific Considerations for HF (Fig. 16.1)
	Diagnosing HF and Biomarkers
	Equity, Diversity and Inclusion (EDI)
	Next Steps and Suggestions
	Conclusion
	References
17 Sex-Dependent Cardiac Fibrosis After Myocardial Infarction: A Function of Differential Periostin Signaling?
	Introduction
	Myocardial Infarction and Cardiac Fibrosis in Males and Females
	Biology of Periostin
	Periostin in Post MI Cardiac Interstitial Remodeling
	Periostin’s Role in Male and Female Post-MI Patients
	Cardiovascular Disease Progression is Distinct in Male and Female Patients
	Summary
	References
18 A Narrative Review of the Vascular Consequences of Estrogen Deficiency: A Focus on Female Athletes with Functional Hypothalamic Amenorrhea
	Introduction
	Ovarian Disruption in Exercising Premenopausal Women
	Cardiovascular Consequences of Ovarian Dusruption in Premenopausal Women
	Nitric Oxide and the Endothelium: Effects of Estrogen, Exercise and Caloric Restriction
	Vascucular Findings in EAA: Endothelial Function
	Restoration of Endothelial Function in EAA
	Arterial Stiffness: Effects of Estrogen, Exercise and Caloric Restriction
	Vascular Findings in EAA: Arterial Stiffness
	Intima Media Thickness: Effects of Estrogen, Exercise and Caloric Restriction
	Vascular Findings in EAA: Intima Media Thickness
	Summary and Conclusion
	References
19 Depression and Anxiety in Women with Coronary Artery Disease: Prevalence and Links to Adverse Cardiac Outcomes
	The Burden of Anxiety and Depression
	Prevalence of Depression and Anxiety in Cardiac Disease
	Effects of Depression and Anxiety on Cardiac Outcomes
	Explanatory Mechanisms Linking Depression, Anxiety and Cardiac Outcomes
	Sex Differences in the Prevalence of Depression and Anxiety in Patients with Cardiac Disease
	Sex Differences in the Prognostic Effects of Depression and Anxiety on Adverse Cardiac Outcomes
	Recommendations for Future Research and Clinical Practice
	Conclusion
	References
20 Cardiac Imaging in Women with Suspected Ischemic Heart Disease
	Introduction
	Stress Echocardiography
	Myocardial Perfusion Imaging with SPECT and PET
		Single Photon Emission Computed Tomography (SPECT)
		Positron Emission Tomography (PET)
	Computed Tomography (CT)
		Coronary Artery Calcium Scoring
		Coronary CT Angiography
	Cardiac Magnetic Resonance Imaging (MRI)
	Cardiac Imaging in Pregnancy
	Conclusion
	References
21 Heart Ischemia/Reperfusion Injury—Is the Female Equally Protected Compared to Male?
	Introduction
	Conclusion
	References
22 Engaging Women in Decisions About Their Heart Health
	Introduction
	Shared Decision Making: Defined
	Shared Decision-Making and Women’s Heart Health
	Interventions to Facilitate Shared Decision-Making
	Implementation of Shared Decision-Making in Clinical Practice
	Conclusion and Future Directions
	References
23 Sex Differences in the Function of Cardiac Sodium-Calcium Exchanger in Physiological and Pathophysiological Settings: Implications for Cardiac Arrhythmias
	Overview of Cardiac Ca2+ Handling and Its Gender Differences
	The Role of the Na+/Ca2+ Exchanger in Ventricular Myocytes
	Sex Differences in the NCX-Expression and Genomic Regulation
	Sex-Related Role of NCX in Ca2+ Handling Balance
	Sex-Related Differences of NCX in Myocardial Ischemia
	Sex-Related Changes of NCX in Heart Failure
	Conclusion
	References
24 Role of Estrogen in Attenuating Apoptosis and Cardiac Dysfunction in Female Heart Failure
	Introduction
	Sex Differences in Heart Failure
	Effects of Estrogen and Cardiac Dysfunction in Female Heart Failure
	Mechanisms of Modification of Cardiomyocyte Apoptosis in Female Failing Hearts by Estrogen Treatment
	Experimental Evidence for the Effects of Ovariectomy and Estrogen Therapy on Cardiac Dysfunction and Apoptosis in Female Heart Failure Due to Volume Overload
	Conclusion
	References
25 Prevention of β-Adrenoceptor-Mediated Alterations in Female Heart Failure by Estrogen
	Introduction
	Role of β-AR-Signal Transduction in Heart Function
	Sex Differences in Cardiovascular Disease
	Sex Differences in the β-AR Mechanisms in Heart Failure Due to Volume Overload
	Conclusion
	References
26 Cardiovascular Consequences of Metabolic Disturbances in Women
	Introduction
	Sex Differences in Lifestyle and Risk Factors of Metabolic Syndrome
	Insulin Resistance and Association with Cardiovascular Diseases
	Sex-Related Differences in Cardiac Function
	Metabolic Disturbances in the Heart Induce Cardiovascular Dysfunction in Women
	Conclusions
	References