Key result
Cardiac 18F-DOPA uptake was higher in women compared to men, with the difference most pronounced in the left ventricular apex and in individuals over 55 years of age.
Why the study?
Are there age- and sex-dependent changes in regional cardiac sympathetic activity assessed by 18F-DOPA PET imaging?
Cross-Sectional (n=133)
No
Are there age- and sex-dependent changes in regional cardiac sympathetic activity assessed by 18F-DOPA PET imaging?
Women show a prominent age-related increase in myocardial 18F-DOPA uptake, particularly in the LV apex, suggesting sex-specific changes in regional cardiac sympathetic activity that may relate to conditions like Takotsubo cardiomyopathy.
Answers are grounded in this paper and cite their sources.
Suggests sex- and age-dependent cardiac sympathetic differences; hypothesis-generating for Takotsubo cardiomyopathy predisposition in older women.
BACKGROUND: Sexual dimorphism in cardiac sympathetic outflow has recently gained attention in the context of Takotsubo cardiomyopathy. Previous studies suggest that there are sex- and age-dependent differences in peripheral autonomic control, however, data on cardiac-specific sympathetic activation in aged women and men are lacking. METHODS AND RESULTS: Regional quantitative analysis of cardiac fluorine-18 (18F)- Dihydroxyphenylalanine (DOPA) uptake was retrospectively performed in 133 patients (69 females, mean age 52.4±17.7 years) referred for assessment of neuroendocrine tumours (NET) by Positron-Emission-Tomography. Cardiac 18F-DOPA uptake was significantly higher in women as compared to men (1.33±0.21 vs. 1.18±0.24, p<0.001). This sex-difference was most pronounced in the apical region of the left ventricle (LV, 1.30±0.24 in women vs. 1.13±0.25 in men, p<0.001) and in individuals >55 years of age (1.39±0.25 in women vs. 1.09±0.24 in men, p<0.001). Women showed a prominent increase in myocardial 18F-DOPA uptake with age with the strongest increase seen in the LV apical region (r = 0.34, p = 0.004). Accordingly, sex and age were selected as significant predictors of LV apical 18F-DOPA uptake in a stepwise linear regression model. No age-dependent changes of cardiac 18F-DOPA uptake were observed in men or in the right ventricular region. CONCLUSION: Our study suggests that aging is related to sex-specific changes in regional cardiac sympathetic activity. Future studies will have to assess whether the increase in LV apical 18F-DOPA uptake with age in women is of pathogenic relevance for the higher susceptibility of postmenopausal women to conditions associated with increased sympathetic activity.
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Burger et al. (2018) conducted a cross-sectional in Neuroendocrine tumours (NET) assessment without cardiovascular disease (n=133). Female sex and older age vs. Male sex and younger age was evaluated on Cardiac 18F-DOPA uptake (SUVmax-N) (p=<0.001). Cardiac 18F-DOPA uptake was higher in women compared to men, with the difference most pronounced in the left ventricular apex and in individuals over 55 years of age.
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