Sex differences in heart: from basics to clinics

Area of Science:

• Cardiovascular Physiology
• Sex Differences in Medicine
• Cardiac Electrophysiology

Background:

• Significant sex-based variations exist in human heart structure and function.
• Electrocardiogram (ECG) patterns, including T-wave amplitude and ST angle, differ between men and women.
• Women generally exhibit longer QT duration, increasing susceptibility to drug-induced torsades de pointes.

Purpose of the Study:

• To summarize sex-dependent differences in normal cardiac physiology.
• To explore the role of sex hormones in cardiac function and drug responses.
• To highlight the potential of human induced pluripotent stem cell-derived cardiomyocytes in elucidating sex-based cardiac mechanisms.

Main Methods:

• Review of existing literature on sex differences in cardiac physiology and disease.
• Analysis of ECG pattern variations between sexes.
• Discussion of the influence of sex hormones on cellular functions and adrenergic regulation.

Main Results:

• Men's ECG patterns show higher T-wave amplitude and increased ST angle.
• Women have longer QT duration and are more prone to specific arrhythmias.
• Cardiovascular disease prevalence, severity, and prognosis also demonstrate sex-based disparities.

Conclusions:

• Sex differences in cardiac physiology are clinically recognized but poorly understood at the mechanistic level.
• Sex hormones significantly influence cardiac repolarization and adrenergic responses.
• Further research using models like iPSC-derived cardiomyocytes is essential to unravel these sex-specific mechanisms.