While cardiovascular mortality rates in men have steadily declined since the 1980s, the disease is becoming more common in women, with cardiovascular deaths in women currently exceeding those in men. In fact, clinical outcomes from acute coronary syndrome and heart failure are consistently worse for women than men (Figure 1). However, the gender-specific environmental, molecular, and cellular variables that contribute to cardiovascular disease are largely unknown; patients are treated the same regardless of sex.
We recently observed significant sex- and age-specific differences in baseline left ventricular ejection fraction (LVEF), with a strong age-dependent increase in LVEF observed in healthy women but not in men (Figure 2). Given the prognostic importance of LVEF and its routine use in clinical decision making, understanding the variables that modulate myocardial contractility and vulnerability to cardiac injury in postmenopausal females and older males is of paramount importance for the development of personalized age- and gender-based therapies. In our current projects we therefore assess the impact of (patho)physiological factors contributing to sex- and age-related differences in cardiac function (Figure 3). More precisely, we are studying the extent to which these sex-differences can be attributed to sex hormones and their receptors, to differences in genetic predisposition, neurohumoral signalling, and gender-based lifestyle factors. For this purpose, we are using murine experimental models and a variety of in vivo imaging modalities including serial positron-emissions tomography, echocardiography and cardiovascular magnetic resonance imaging. Our ultimate goal is to improve and personalise gender-based therapeutic approaches in the aging population.
Figure 1: Gender differences in cardiovascular disease
Figure 2: Sex-related differences in left ventricular ejection fraction (LVEF) in different age groups assessed by single-photon emissions tomography (right). *p<0.05.
Figure 3: Potential variables contributing to sex- and age-related differences in cardiac function. LVEF, left ventricular ejection fraction.
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CAS Sex- and Gender-Specific Medicine: Link
Prof. Catherine Gebhard MD, PhD
Tel. +41 44 255 89 19
Catherine Gebhard MD, PhD, Attending Physician/Research Group Leader
Susan Bengs, PhD, Deputy Group Leader/Project Manager
Karin Peer, Secretary (Office firstname.lastname@example.org)
Michael Fiechter MD, PhD, Clinical Research Fellow
Ahmed Haider, PhD, PostDoc
Geoffrey Warnock, PhD, PostDoc
Winandus Wijnen, PhD, PostDoc
Alexander Meisel MD, Clinical Research Fellow
Angela Portmann, MSc, PhD Student
Dominik Etter, BSc, Research Assistant
Flavia Diggelmann, pract. med., Medical Postgraduate
Katja Knechtle, pract. med., Medical Postgraduate
Anna-Luisa Beeler, Medical Master Student
Katharina Schade, Medical Master Student
Yves Pargätzi, Medical Master Student
Anja Zabel, Study Coordination