Sex-related differences in ventricular remodeling after myocardial infarction

Aimo, Alberto; Panichella, Giorgia; Barison, Andrea; Maffei, Silvia; Cameli, Matteo; Coiro, Stefano; D’Ascenzi, Flavio; Mario, Carlo Di; Liga, Riccardo; Marcucci, Rossella; Morrone, Doralisa; Olivotto, Iacopo; Tritto, Isabella; Emdin, Michele

doi:10.1016/j.ijcard.2021.07.036

Cited by 16 publications

(11 citation statements)

References 101 publications

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“…Coronary heart disease (CHD) and stroke are two major forms of CVD, accounting for 84.9% of deaths combined (1). Evidence indicates that sex has different effects on the manifestations and prognosis of CVD (2)(3)(4). In men, CHD is the initial manifestation; however, in women, it can present as stroke or heart failure.…”

Section: Introductionmentioning

confidence: 99%

Low Serum Dehydroepiandrosterone and Dehydroepiandrosterone Sulfate Are Associated With Coronary Heart Disease in Men With Type 2 Diabetes Mellitus

et al. 2022

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AimsSex hormones play an important role in the pathogenesis of cardiovascular disease (CVD). This cross-sectional study aimed to explore the associations of dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEAS) with coronary heart disease (CHD) and stroke in middle-aged and elderly patients with type 2 diabetes mellitus (T2DM).Materials and MethodsA total of 995 patients with T2DM were included in the study analysis. Serum levels of DHEA and DHEAS were quantified using liquid chromatography–tandem mass spectrometry. Binary logistic regression analyses were performed to assess the associations of DHEA and DHEAS with CHD and stroke. Receiver operating characteristic (ROC) curve analysis was performed to determine the optimal DHEA and DHEAS cutoff values for the detection of CHD in men with T2DM.ResultsIn men with T2DM, after adjustment for potential confounders in model 3, the risk of CHD decreased with an increasing serum DHEA level [odds ratio (OR) = 0.38, quartile 4 vs. quartile 1; 95% confidence interval (CI) = 0.16–0.90; p = 0.037 for trend). Consistently, when considered as a continuous variable, this association remained significant in the fully adjusted model (OR = 0.59, 95% CI = 0.40–0.87, p < 0.05). When taken as a continuous variable in model 3, serum DHEAS level was also inversely related to the risk of CHD among men (OR = 0.56, 95% CI = 0.38–0.82, p < 0.05). Similarly, this relationship remained statistically significant when DHEAS was categorized into quartiles (OR = 0.27, quartile 4 vs. quartile 1; 95% CI = 0.11–0.67; p = 0.018 for trend). ROC curve analyses revealed that the optimal cutoff values to detect CHD in men with T2DM were 6.43 nmol/L for DHEA and 3.54 μmol/L for DHEAS. In contrast, no significant associations were found between DHEA and DHEAS on the one hand and stroke on the other in men and women with T2DM (all p > 0.05).ConclusionsSerum DHEA and DHEAS were significantly and negatively associated with CHD in middle-aged and elderly men with T2DM. This study suggests potential roles of DHEA and DHEAS in CHD pathogenesis.

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Section: Introductionmentioning

confidence: 99%

Low Serum Dehydroepiandrosterone and Dehydroepiandrosterone Sulfate Are Associated With Coronary Heart Disease in Men With Type 2 Diabetes Mellitus

et al. 2022

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“…In contrast, microvascular obstruction areas (also knowns as “no-reflow”) following myocardial infarction (MI) remodeling are smaller in women and more presumably linked to distal atherothrombotic embolization, microvascular impairment, and reperfusion insult [ 36 ].…”

Section: Cardiovascular Risk Factors In Womenmentioning

confidence: 99%

Update on Management of Cardiovascular Diseases in Women

Lucà¹,

Abrignani

Parrini

et al. 2022

JCM

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Cardiovascular diseases (CVD) have a lower prevalence in women than men; although, a higher mortality rate and a poorer prognosis are more common in women. However, there is a misperception of CVD female risk since women have commonly been considered more protected so that the real threat is vastly underestimated. Consequently, female patients are more likely to be treated less aggressively, and a lower rate of diagnostic and interventional procedures is performed in women than in men. In addition, there are substantial sex differences in CVD, so different strategies are needed. This review aims to evaluate the main gender-specific approaches in CVD.

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“…At the same time, TIMPs are activated, leading to collagen accumulation and scar formation. After around 2 weeks, the scar begins to maturate, as the deposition of collagen increases and leukocytes and fibroblasts are cleared, most probably through apoptosis [ 53 , 54 , 55 , 56 , 57 , 58 ].…”

Section: Pathophysiology Of Adverse Remodelingmentioning

confidence: 99%

“…It appears that in ischemic cardiomyopathy, there is no difference in the incidence of adverse remodeling between sexes. However, women have a lower predisposition to develop spherical distortion of the left ventricle, but a higher risk than men of developing HF [ 58 ]. In contrast, in non-ischemic cardiomyopathy, the rate of reverse remodeling is similar between sexes, but women have better outcomes [ 110 ].…”

Section: Therapeutic Implications In Adverse Cardiac Remodelingmentioning

confidence: 99%

“…In contrast, in non-ischemic cardiomyopathy, the rate of reverse remodeling is similar between sexes, but women have better outcomes [ 110 ]. The different response to therapy in adverse remodeling might be due to the fact that women develop less inflammation and apoptosis, with a less extended infarct area; sex hormones contribute to these processes [ 58 ]. Recent studies demonstrated that guideline-directed medical therapy, including angiotensin receptor neprilysin inhibitors promoting reverse remodeling both in ischemic and non-ischemic cardiomyopathy, improve the mortality and hospitalizations for HF.…”

Section: Therapeutic Implications In Adverse Cardiac Remodelingmentioning

confidence: 99%

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Left Ventricular Remodeling after Myocardial Infarction: From Physiopathology to Treatment

Leancă

Crișu

Petriş

et al. 2022

Life

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Myocardial infarction (MI) is the leading cause of death and morbidity worldwide, with an incidence relatively high in developed countries and rapidly growing in developing countries. The most common cause of MI is the rupture of an atherosclerotic plaque with subsequent thrombotic occlusion in the coronary circulation. This causes cardiomyocyte death and myocardial necrosis, with subsequent inflammation and fibrosis. Current therapies aim to restore coronary flow by thrombus dissolution with pharmaceutical treatment and/or intravascular stent implantation and to counteract neurohormonal activation. Despite these therapies, the injury caused by myocardial ischemia leads to left ventricular remodeling; this process involves changes in cardiac geometry, dimension and function and eventually progression to heart failure (HF). This review describes the pathophysiological mechanism that leads to cardiac remodeling and the therapeutic strategies with a role in slowing the progression of remodeling and improving cardiac structure and function.

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Sex-related differences in ventricular remodeling after myocardial infarction

Cited by 16 publications

References 101 publications

Low Serum Dehydroepiandrosterone and Dehydroepiandrosterone Sulfate Are Associated With Coronary Heart Disease in Men With Type 2 Diabetes Mellitus

Low Serum Dehydroepiandrosterone and Dehydroepiandrosterone Sulfate Are Associated With Coronary Heart Disease in Men With Type 2 Diabetes Mellitus

Update on Management of Cardiovascular Diseases in Women

Left Ventricular Remodeling after Myocardial Infarction: From Physiopathology to Treatment

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