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Sex Differences in the Association between Inflammation and Ischemic Heart Disease


Abstract

BACKGROUND
Inflammation plays a fundamental role in mediating all stages of atherosclerosis. Given the higher prevalence of inflammatory rheumatologic conditions in women and the female propensity towards worse cardiovascular outcomes, refined strategies are needed to better identify the high-risk female cardiovascular phenotype.
OBJECTIVES
This article aims to assess sex-specific links between inflammatory processes and the development and progression of ischemic heart disease.
PATIENTS AND METHODS
The relationship between vertebral bone marrow metabolism-a marker of inflammation-and myocardial injury was retrospectively assessed in 294 patients (28.6% women, mean age: 66.9 ± 10.0 years) who underwent F-fluorodeoxyglucose (F-FDG) positron emission tomography (PET) and Tc-tetrofosmin single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI).
RESULTS
A significant increase in F-FDG bone marrow uptake was observed in women with impaired myocardial perfusion (SPECT-MPI) as compared to women with normal myocardial perfusion (standardized uptake value [SUV]: 2.2 ± 1.2 vs. 1.7 ± 0.5,  = 0.013), while no such difference was observed in men (SUV: 1.6 ± 0.8 vs. 1.6 ± 0.4,  = 0.372). Furthermore, a significant inverse correlation between left ventricular ejection fraction (LVEF) and bone marrow metabolism was seen in women ( = -0.229,  = 0.037), but not in men ( = -0.075,  = 0.289). Accordingly, in women, but not in men, bone marrow activity was identified as an independent predictor of both, reduced LVEF (-coefficient, -4.537;  = 0.040) and impaired myocardial perfusion (β-coefficient, 0.138;  = 0.014).
CONCLUSION
A strong link between bone marrow metabolism and impaired myocardial function and perfusion was observed in women, but not in men. Our data suggest that novel biomarkers of inflammation might help to identify women at risk for ischemic cardiomyopathy and to tailor disease management to the female cardiovascular phenotype.

Abstract

BACKGROUND
Inflammation plays a fundamental role in mediating all stages of atherosclerosis. Given the higher prevalence of inflammatory rheumatologic conditions in women and the female propensity towards worse cardiovascular outcomes, refined strategies are needed to better identify the high-risk female cardiovascular phenotype.
OBJECTIVES
This article aims to assess sex-specific links between inflammatory processes and the development and progression of ischemic heart disease.
PATIENTS AND METHODS
The relationship between vertebral bone marrow metabolism-a marker of inflammation-and myocardial injury was retrospectively assessed in 294 patients (28.6% women, mean age: 66.9 ± 10.0 years) who underwent F-fluorodeoxyglucose (F-FDG) positron emission tomography (PET) and Tc-tetrofosmin single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI).
RESULTS
A significant increase in F-FDG bone marrow uptake was observed in women with impaired myocardial perfusion (SPECT-MPI) as compared to women with normal myocardial perfusion (standardized uptake value [SUV]: 2.2 ± 1.2 vs. 1.7 ± 0.5,  = 0.013), while no such difference was observed in men (SUV: 1.6 ± 0.8 vs. 1.6 ± 0.4,  = 0.372). Furthermore, a significant inverse correlation between left ventricular ejection fraction (LVEF) and bone marrow metabolism was seen in women ( = -0.229,  = 0.037), but not in men ( = -0.075,  = 0.289). Accordingly, in women, but not in men, bone marrow activity was identified as an independent predictor of both, reduced LVEF (-coefficient, -4.537;  = 0.040) and impaired myocardial perfusion (β-coefficient, 0.138;  = 0.014).
CONCLUSION
A strong link between bone marrow metabolism and impaired myocardial function and perfusion was observed in women, but not in men. Our data suggest that novel biomarkers of inflammation might help to identify women at risk for ischemic cardiomyopathy and to tailor disease management to the female cardiovascular phenotype.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Diagnostic and Interventional Radiology
04 Faculty of Medicine > University Hospital Zurich > Klinik für Konsiliarpsychiatrie und Psychosomatik
04 Faculty of Medicine > University Hospital Zurich > Clinic for Nuclear Medicine
04 Faculty of Medicine > University Hospital Zurich > Clinic for Cardiology
04 Faculty of Medicine > Center for Molecular Cardiology
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Hematology
Language:English
Date:1 September 2019
Deposited On:31 Jul 2019 13:21
Last Modified:29 Jul 2020 11:02
Publisher:Georg Thieme Verlag
ISSN:0340-6245
OA Status:Closed
Publisher DOI:https://doi.org/10.1055/s-0039-1692442
PubMed ID:31226718

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