STATE-OF-THE-ART PAPER
Sex-Related Differences in Myocardial Remodeling
Maddalena Piro, MD, PhD*,*,
Roberta Della Bona, MD*,
Antonio Abbate, MD, PhD*, ,
Luigi M. Biasucci, MD* and
Filippo Crea, MD*
* Catholic University of the Sacred Heart, Rome, Italy
VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia
Manuscript received February 13, 2009;
revised manuscript received July 27, 2009,
accepted September 1, 2009.
* Reprint requests and correspondence: Dr. Maddalena Piro, Catholic University of the Sacred Heart, Department of Cardiology, Largo A. Gemelli 8, Rome 00168, Italy (Email: prmarilena{at}tiscali.it).
Sex has a profound impact on myocardial remodeling, which is defined as the molecular and cellular events after an injury to the myocardium (i.e., necrosis, pressure overload, volume overload, and aging) leading to a change in shape, dimension, and function of cardiac chambers. Indeed, experimental studies and post-mortem and observational clinical studies suggest the presence of important differences in myocardial remodeling between females and males in response to different types of injures including aging, pressure and volume overload, and myocardial infarction. Interestingly, the remodeling process appears to be more favorable in women versus men; women are more likely to present heart failure with preserved systolic function and are at greater risk for low output syndrome acutely. These differences between men and women are widely held to be related to sex hormones such as estrogen, although the molecular effects of estrogen on ventricular cardiomyocytes are incompletely understood. In this review, we summarize the evidence supporting these notions and discuss the underlying mechanisms and the clinical implications.
Key Words: sex • myocardial remodeling • estrogen • cardiomyopathy
|
Abbreviations and Acronyms
| | ANF = atrial natriuretic factor | | EF = ejection fraction | | EPC = endothelial progenitor cell | | ER = estrogen receptor | | IGF = insulin growth factor | | LV = left ventricle/ventricular | | LVH = left ventricular hypertrophy | | MI = myocardial infarction | | mRNA = messenger ribonucleic acid | | MSC = mesenchymal stem cell | | SHR = spontaneously hypertensive rat |
|
Related Article
-
Inside This Issue
J. Am. Coll. Cardiol. 2010 55: A27.
[Full Text]
[PDF]
This article has been cited by other articles:
|
|
|
|
 
I. Eitel, S. Desch, S. de Waha, G. Fuernau, M. Gutberlet, G. Schuler, and H. Thiele
Sex Differences in Myocardial Salvage and Clinical Outcome in Patients With Acute Reperfused ST-Elevation Myocardial Infarction: Advances in Cardiovascular Imaging
Circ Cardiovasc Imaging,
January 1, 2012;
5(1):
119 - 126.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
W. H. Gaasch and M. R. Zile
Left Ventricular Structural Remodeling in Health and Disease: With Special Emphasis on Volume, Mass, and Geometry
J. Am. Coll. Cardiol.,
October 18, 2011;
58(17):
1733 - 1740.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. Murphy
Estrogen Signaling and Cardiovascular Disease
Circ. Res.,
September 2, 2011;
109(6):
687 - 696.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. W. De Keulenaer and D. L. Brutsaert
Systolic and Diastolic Heart Failure Are Overlapping Phenotypes Within the Heart Failure Spectrum
Circulation,
May 10, 2011;
123(18):
1996 - 2005.
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. A. Borlaug
Discerning Pulmonary Venous From Pulmonary Arterial Hypertension Without the Help of a Catheter
Circ Heart Fail,
May 1, 2011;
4(3):
235 - 237.
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. J. Campbell, J. B. Somaratne, A. J. Jenkins, D. L. Prior, M. Yii, J. F. Kenny, A. E. Newcomb, D. J. Kelly, and M. J. Black
Differences in Myocardial Structure and Coronary Microvasculature Between Men and Women With Coronary Artery Disease
Hypertension,
February 1, 2011;
57(2):
186 - 192.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
W. Shim, A. Mehta, S. Y. Lim, G. Zhang, C. H. Lim, T. Chua, and P. Wong
G-CSF for stem cell therapy in acute myocardial infarction: friend or foe?
Cardiovasc Res,
January 1, 2011;
89(1):
20 - 30.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Cheng, V. Xanthakis, L. M. Sullivan, W. Lieb, J. Massaro, J. Aragam, E. J. Benjamin, and R. S. Vasan
Correlates of Echocardiographic Indices of Cardiac Remodeling Over the Adult Life Course: Longitudinal Observations From the Framingham Heart Study
Circulation,
August 10, 2010;
122(6):
570 - 578.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
