Sex-specific influence on cardiac structural remodeling and therapy in cardiovascular disease

Area of Science:

• Cardiology
• Molecular Biology
• Sex Differences in Medicine

Background:

• Cardiovascular diseases (CVDs) are leading causes of death, with differing prevalence and manifestations between sexes.
• Men often present with coronary artery disease (CAD) and myocardial infarction (MI), while post-menopausal women predominantly show hypertension.
• Sex-based disparities in CVDs are linked to genetic and molecular differences in cardiac remodeling pathways like hypertrophy, inflammation, fibrosis, and apoptosis.

Purpose of the Study:

• To review sex-dependent alterations in adverse cardiac remodeling across various CVDs.
• To explore potential therapeutic strategies, including estrogen treatment, for managing sex-specific cardiac remodeling.

Main Methods:

• This is a review article, synthesizing existing research on sex differences in cardiac remodeling.
• The review discusses molecular pathways and clinical presentations of CVDs in men and women.
• Potential therapeutic interventions are examined based on current literature.

Main Results:

• Men and women exhibit distinct patterns of cardiac hypertrophy (eccentric vs. concentric).
• Women generally display reduced inflammation, fibrosis, and apoptosis in heart failure (HF) compared to men.
• Declining estrogen levels after menopause may influence these sex-specific remodeling pathways.

Conclusions:

• Significant sex differences exist in cardiac remodeling associated with CVDs and HF.
• Estrogen appears to play a crucial role in modulating these sex-specific responses.
• Estrogen-based therapies warrant further investigation for treating cardiovascular conditions in women.