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Heart-brain interactions in cardiac and brain diseases: why sex matters
Alexia Rossi1,2, Nidaa Mikail1,2, Susan Bengs1,2
1Department of Nuclear Medicine, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland.
Insights
Sex significantly impacts the intricate connection between the heart and brain, influencing disease development and treatment across the lifespan. Understanding these sex-based differences is crucial for managing cardiovascular and brain disorders.
Area of Science:
- Cardiology
- Neurology
- Sex Differences in Medicine
Background:
- Cardiovascular disease and brain disorders are prevalent, impacting quality of life.
- A complex network links the heart and brain through physiological and neurohumoral circuits.
- Shared risk factors (hypertension, diabetes, smoking) and systemic inflammation affect both organs.
Purpose of the Study:
- To review contemporary evidence on the effect of sex on heart-brain interactions.
- To explore how these interactions influence the pathogenesis and clinical manifestations of heart and brain diseases.
- To examine sex-related differences in treatment responses for these conditions.
Main Methods:
- Literature review of current research on heart-brain interactions.
- Analysis of studies investigating sex and gender influences on cardiovascular and neurological conditions.
- Synthesis of evidence regarding pathophysiological mechanisms and clinical outcomes.
Main Results:
- Sex and gender significantly modify heart-brain interactions throughout the lifespan.
- These sex-based differences affect disease development, presentation, and progression.
- Evidence suggests varying treatment responses based on sex and gender.
Conclusions:
- Sex-based differences are critical in understanding heart-brain crosstalk.
- Acknowledging these differences is essential for personalized medicine in cardiovascular and brain disorders.
- Further research is needed to elucidate sex-specific mechanisms and optimize therapeutic strategies.
Abstract:
Cardiovascular disease and brain disorders, such as depression and cognitive dysfunction, are highly prevalent conditions and are among the leading causes limiting patient's quality of life. A growing body of evidence has shown an intimate crosstalk between the heart and the brain, resulting from a complex network of several physiological and neurohumoral circuits. From a pathophysiological perspective, both organs share common risk factors, such as hypertension, diabetes, smoking or dyslipidaemia, and are similarly affected by systemic inflammation, atherosclerosis, and dysfunction of the neuroendocrine system. In addition, there is an increasing awareness that physiological interactions between the two organs play important roles in potentiating disease and that sex- and gender-related differences modify those interactions between the heart and the brain over the entire lifespan. The present review summarizes contemporary evidence of the effect of sex on heart-brain interactions and how these influence pathogenesis, clinical manifestation, and treatment responses of specific heart and brain diseases.
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