Heart failure, aging are gender-specific

For The News-Letter

Gender-specific treatments of heart failure may need to be developed in order to compensate for differences in male and female hearts, according to a new study.

The study, which was conducted by researchers at the Johns Hopkins School of Medicine, does not explain exactly what these differences can be attributed to, but they do hint at why different forms of heart failure are experienced by each gender.

Heart failure, characterized by the general weakening of the heart muscle and the eventual loss of blood supply, affects more than five million Americans. In the past, cardiologists have prescribed medications that reduce the size of the heart muscle, but the results of this study show that women would not benefit as much as men from these medications.

This research, which was published in the journal Radiology on Oct. 20, differs from previous studies in its use of the Magnetic Resonance Imaging (MRI) scan. In the past, the heart’s changes had been studied using ultrasound, but MRI scans provide more detailed images and ultimately more reliable information. The researchers analyzed MRI scans of nearly 3,000 adults. By using MRI scans, the doctors were able to achieve a greater understanding of how each heart developed individually.

According to the results, the left ventricle, which fills with and then pushes out blood, gets smaller over time. In men the heart muscle that surrounds the chamber grows bigger and thicker with age, while in women this muscle remains the same size or gets smaller.

Thicker muscles and smaller ventricles are both signs of increasing potential heart failure, but the differences in development suggest that each gender develops the disease for different reasons.

The results of the study show that, over a period of 10 years, the average male’s left ventricle increased by eight grams, while the average woman’s decreased by 1.6 grams. The heart’s filling capacity declined in both genders but more so in women, who experienced a decrease of 13 milliliters (compared to men’s 10 milliliters).

Senior study author Joao Lima stated that the different pathophysiology of male and female hearts may necessitate gender-specific heart treatments. Hearts can no longer be looked at and treated as the same for each person, as there is now definitive proof that this vital organ changes differently according to the gender of the patient.

The study is part of a continuing investigation called the Multi-Ethnic Study of Atherosclerosis (MESA), which follows approximately 7,000 men and women to determine the patterns in the development of heart disease or heart failure and which factors contribute to the development of the disease.

While the results of this investigation shed light on the treatment of heart disease, the research team notes that the study does not show what causes the difference in physiology. The team acknowledges that this difference should be studied further.

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