Gender Differences in Ischemic Cardiomyopathy

Divoky, Laura; Maran, Anbukarasi; Ramu, Bhavadharini

doi:10.1007/s11883-018-0750-x

Cited by 26 publications

(40 citation statements)

References 136 publications

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“…Moreover, as gender also influences pathophysiology of cardiomyopathy variable gender was made to a propensity-score matching variable in order to reduce gender-related bias. As Divoky et al 32 and Löchel et al 33 have already presented, the nuances of gender-specific differences are wide-spread in terms of device indication, implantation and postoperative therapy. In our study more women suffered from idiopathic than from ischaemic cardiomyopathy.…”

Section: Discussionmentioning

confidence: 98%

Comparative analysis of LVAD patients in regard of ischaemic or idiopathic cardiomyopathy: A propensity-score analysis of EUROMACS data

et al. 2022

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Background: Despite recent advances in management of patients with advanced heart failure, mortality remains high. Aim of this study was to compare impact of different aetiology of ischaemic and idiopathic cardiomyopathy on early outcomes and long-term survival of patients after left ventricular assist device implantation. Methods: European Registry for Patients with Mechanical Circulatory Support (EUROMACS) gathers clinical data and follow-up parameters of LVAD recipients. Patients enrolled in the EUROMACS registry with primary diagnosis of either ischaemic ( n = 1190) or idiopathic ( n = 812) cardiomyopathy were included. Primary Endpoints were early mortality as well as long-term survival. Secondary endpoint were major postoperative adverse events, such as need for rethoracotomy. Additionally, a propensity-score matching analysis was performed for patients with ischaemic ( n = 509) and idiopathic ( n = 509) cardiomyopathy. Results: In terms of basic demographics and baseline parameters the two groups significantly differed as expected before propensity-score matching due to different aetiology of cardiomyopathy. Seven-day (52 (4.4%) versus 18 (2.2%); p = 0.009), 30-day (153 (12.9%) versus 73 (9.0%); p = 0.008) and in-hospital mortality (253 (19.7%) versus 123 (15.1%); p = 0.009) were significantly lower in the idiopathic cardiomyopathy group compared to the ischaemic cardiomyopathy group, whereas after propensity-score matching 30-day ( p = 0.169) was comparable and in-hospital mortality ( p = 0.051) was almost significant. Kaplan-Meier survival analysis revealed no significant difference in regard of long-term survival after propensity-score matching (Breslow-test p = 0.161 and LogRank-test p = 0.113). Conclusion: Though patients with ischaemic and idiopathic cardiomyopathy suffer from different cardiomyopathy aetiologies, 30-day-mortality and long-term survival of both groups were similar leading to the conclusion that covariates predominately influence mortality and survival of ischaemic and idiopathic cardiomyopathies.

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Section: Discussionmentioning

confidence: 98%

Comparative analysis of LVAD patients in regard of ischaemic or idiopathic cardiomyopathy: A propensity-score analysis of EUROMACS data

et al. 2022

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“…Sex differences are found in a number of syndromes and diseases in addition to the differences between males and females found in many physiological functions 27–29 . For example, menopausal women have more severe manifestations of cardiovascular diseases and hypertension than men due to the physical functions of sex hormones.…”

Section: Discussionmentioning

confidence: 99%

Estrogen negatively regulates the renal epithelial sodium channel (ENaC) by promoting Derlin-1 expression and AMPK activation

Zhang

Bukhari

et al. 2019

Exp Mol Med

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The main functions of the epithelial sodium channel (ENaC) in the kidney distal nephron are mediation of sodium and water balance and stabilization of blood pressure. Estrogen has important effects on sodium and water balance and on premenopausal blood pressure, but its role in the regulation of ENaC function is not fully understood. Female Sprague–Dawley rats were treated with 17β-estradiol for 6 weeks following bilateral ovariectomy. Plasma estrogen, aldosterone, creatinine, and electrolytes were analyzed, and α-ENaC and derlin-1 protein expression in the kidney was determined by immunohistochemistry and western blotting. The expression levels of α-ENaC, derlin-1, AMPK, and related molecules were also examined by western blotting and real-time PCR in cultured mouse renal collecting duct (mpkCCDc14) epithelial cells following estrogen treatment. Immunofluorescence and coimmunoprecipitation were performed to detect α-ENaC binding with derlin-1 and α-ENaC ubiquitination. The results demonstrated that the loss of estrogen elevated systolic blood pressure in ovariectomized (OVX) rats. OVX rat kidneys showed increased α-ENaC expression but decreased derlin-1 expression. In contrast, estrogen treatment decreased α-ENaC expression but increased derlin-1 expression in mpkCCDc14 cells. Moreover, estrogen induced α-ENaC ubiquitination by promoting the interaction of α-ENaC with derlin-1 and evoked phosphorylation of AMPK in mpkCCDc14 cells. Our study indicates that estrogen reduces ENaC expression and blood pressure in OVX rats through derlin-1 upregulation and AMPK activation.

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“…Importantly the investigators performed subgroup analyses and showed a significant interaction for sex, with less benefit in female compared to male patients. Based on the female under-representation in randomized VT ablation trials, their results may not be fully applicable to women [58,59]. As shown in the subgroup analysis of the PAUSE-SCD trial, women may confer no or less benefit from ablation compared to men, though these results should not be over-interpreted as they are based on small sample sizes.…”

Section: Randomized Trialsmentioning

confidence: 99%

Sex differences in ventricular arrhythmia: epidemiology, pathophysiology and catheter ablation

Krisai¹,

Cheniti²,

Takagi³

et al. 2022

Rev. Cardiovasc. Med.

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Evidence on sex differences in the pathophysiology and interventional treatment of ventricular arrhythmia in ischemic (ICM) or nonischemic cardiomyopathies (NICM) is limited. However, women have different etiologies and types of structural heart disease due to sex differences in genetics, proteomics and sex hormones. These differences may influence ventricular electrophysiological parameters and may require different treatment strategies. Considering that women were consistently under-represented in all randomized-controlled trials on VT ablation, the applicability of the study results to female patients is not known. In this article, we review the current knowledge and gaps in evidence about sex differences in the epidemiology, pathophysiology and catheter ablation in patients with ventricular arrhythmias.

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Gender Differences in Ischemic Cardiomyopathy

Cited by 26 publications

References 136 publications

Comparative analysis of LVAD patients in regard of ischaemic or idiopathic cardiomyopathy: A propensity-score analysis of EUROMACS data

Comparative analysis of LVAD patients in regard of ischaemic or idiopathic cardiomyopathy: A propensity-score analysis of EUROMACS data

Estrogen negatively regulates the renal epithelial sodium channel (ENaC) by promoting Derlin-1 expression and AMPK activation

Sex differences in ventricular arrhythmia: epidemiology, pathophysiology and catheter ablation

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