Female gender and left ventricular dysfunction in myocardial surgical revascularization: the strange couple

Congestive heart failure (CHF) a chronic progressive condition, needing lifelong management, associated with poor outcome and shortened survival, is the first cause of hospitalization in the elderly (1-3). Although data from Framingham Heart Study have historically identified arterial hypertension as the primary cause of heart failure (1,2,4), more recent studies suggest that in the developed country, coronary artery disease (CAD) and its complications have become the most common cause of progressive development of severe left ventricular dysfunction with reduced ejection fraction (EF) (1,3,5,6).