Female sex is associated with a more favorable myocardial remodeling process compared to men, with women more likely to present heart failure with preserved systolic function.
What are the sex-related differences and underlying mechanisms in myocardial remodeling after cardiac injury?
This review highlights significant sex-based differences in myocardial remodeling, noting a more favorable profile in women that may contribute to their higher likelihood of developing heart failure with preserved ejection fraction.
Sex has a profound impact on myocardial remodeling, which is defined as the molecular and cellular events after an injury to the myocardium (i.e., necrosis, pressure overload, volume overload, and aging) leading to a change in shape, dimension, and function of cardiac chambers. Indeed, experimental studies and post-mortem and observational clinical studies suggest the presence of important differences in myocardial remodeling between females and males in response to different types of injures including aging, pressure and volume overload, and myocardial infarction. Interestingly, the remodeling process appears to be more favorable in women versus men; women are more likely to present heart failure with preserved systolic function and are at greater risk for low output syndrome acutely. These differences between men and women are widely held to be related to sex hormones such as estrogen, although the molecular effects of estrogen on ventricular cardiomyocytes are incompletely understood. In this review, we summarize the evidence supporting these notions and discuss the underlying mechanisms and the clinical implications.
Piro et al. (Mon,) conducted a review in Myocardial remodeling. Female sex vs. Male sex was evaluated on Myocardial remodeling. Female sex is associated with a more favorable myocardial remodeling process compared to men, with women more likely to present heart failure with preserved systolic function.