Sex Differences in the Association between Inflammation and Ischemic Heart Disease

Area of Science:

• Cardiovascular Medicine
• Nuclear Medicine
• Inflammation Research

Background:

• Inflammation is central to atherosclerosis development.
• Women with inflammatory conditions have higher cardiovascular risks.
• Identifying high-risk female cardiovascular phenotypes requires refined strategies.

Purpose of the Study:

• To investigate sex-specific associations between inflammation and ischemic heart disease.
• To explore the link between bone marrow metabolism and myocardial injury in men and women.

Main Methods:

• Retrospective assessment of 294 patients (28.6% women).
• Utilized 18F-fluorodeoxyglucose (18F-FDG) PET and 99mTc-tetrofosmin SPECT-MPI.
• Correlated vertebral bone marrow metabolism (inflammation marker) with myocardial perfusion and function.

Main Results:

• Women with impaired myocardial perfusion showed significantly higher 18F-FDG bone marrow uptake than those with normal perfusion (SUV: 2.2 vs. 1.7, p=0.013).
• No significant difference in bone marrow uptake was observed between men with normal and impaired perfusion (SUV: 1.6 vs. 1.6, p=0.372).
• Bone marrow metabolism was inversely correlated with left ventricular ejection fraction (LVEF) in women (r=-0.229, p=0.037) but not men (r=-0.075, p=0.289).
• Bone marrow activity independently predicted reduced LVEF and impaired myocardial perfusion in women, but not in men.

Conclusions:

• A significant association exists between bone marrow metabolism and impaired myocardial function and perfusion in women.
• Inflammation markers, specifically bone marrow metabolism, may serve as novel biomarkers for identifying women at risk of ischemic cardiomyopathy.
• These findings suggest the need for tailored disease management strategies for the female cardiovascular phenotype.