Sex-dependent association between inflammation, neural stress responses, and impaired myocardial function

Fiechter, Michael; Haider, Ahmed; Bengs, Susan; Marędziak, Monika; Burger, Irene A.; Roggo, A; Portmann, Angela; Schade, Katharina; Warnock, Geoffrey; Treyer, Valérie; Messerli, Michael; Fuchs, Tobias A.; Pazhenkottil, Aju P.; Buechel, Ronny R.; Kaufmann, Philipp A.; Gebhard, Cathérine

doi:10.1007/s00259-019-04537-8

Cited by 21 publications

(25 citation statements)

References 14 publications

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“…This was associated with increased haemopoietic activity and arterial inflammation thereby suggesting a significant role of a neural-haemopoietic-arterial axis. Moreover, higher amygdalar activation is associated with decreased left ventricular ejection fraction and fixed perfusion defects in women and not men [41].…”

Section: Beyond Biological Sex: Gender Aspects Of Vascular Pathophysimentioning

confidence: 94%

Sex and gender aspects in vascular pathophysiology

2020

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Cardiovascular disease (CVD) is a leading cause of global mortality in men and women. The prevalence, pathophysiology, clinical manifestations and outcomes of CVD observed in these two populations is being increasingly recognized as distinct. In this editorial, we provide an overview of mechanisms related to differences in vascular pathophysiology between men and women and explore the contributions of both sex and gender.

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Section: Beyond Biological Sex: Gender Aspects Of Vascular Pathophysimentioning

confidence: 94%

Sex and gender aspects in vascular pathophysiology

2020

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“…9 Indeed, in a prospective clinical investigation, Tarkin et al recently demonstrated that 68 Ga-DOTATATE can be used to differentiate between highrisk vs. low-risk carotid and coronary atherosclerotic lesions. 10 Further, 68 Ga-DOTATATE was superior to 18 F-FDG-PET in discriminating between high-risk vs. low-risk human atherosclerotic plaques, underlining the capability of SST 2 -targeted tracers in capturing vulnerable plaque features. 11 In contrast to DOTATATE, DOTA-JR11 belongs to the new generation of SST 2 ligands that are based on antagonistic structures and exhibit more favorable receptor binding, pharmacokinetics, and biodistribution properties.…”

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confidence: 94%

“…atherosclerosis, the assessment of 'residual inflammatory risk' has been proposed as a promising strategy for improving CVD risk prediction and providing guidance for novel precision treatments. 3,4 Several molecular imaging modalities including 99m Tc-based single-photon emission computed tomography (SPECT) and 18 F-fluorodeoxyglucose ( 18 F-FDG) positron emission tomography (PET) have been developed for the non-invasive detection of vascular inflammatory activities 5,6 (Figure 1). 18 F-FDG-PET has been used to detect macrophage-rich atherosclerotic lesions and as a surrogate endpoint for vascular interventional drug trials.…”

mentioning

confidence: 99%

“…7 However, it is limited by its moderate reproducibility and sensitivity for the detection of coronary atherosclerotic changes. In addition, 18 F-FDG-PET has logistical and technical constraints including the need to suppress myocardial and peripheral muscle FDG uptake for the analysis as well as the high FDG uptake in structures close to the vessel wall. Hence, given the small size of the atherosclerotic lesion and the continuous cardiac and respiratory movements during PET acquisition, nuclear imaging of atherosclerosis remains challenging.…”

mentioning

confidence: 99%

“…The study by Meester et al did not address this important issue; nonetheless, sexual dimorphism in the association between inflammation and coronary artery disease has recently been demonstrated. 17,18 Further, recent advances in coronary computed tomography angiography (CCTA) technology allow to detect coronary inflammation by capturing perivascular fat attenuation. 19 Given the widespread use of CCTA as well as novel CCTA acquisition techniques ranging in a sub-millisievert fraction of effective radiation dose, 20 the prognostic performance of SST 2 -targeted probes will have to be validated against novel imaging biomarkers derived from CCTA before they may advance from research tools to clinical applications.…”

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confidence: 99%

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Imaging inflammation in atherosclerosis: Exploring all avenues

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Despite remarkable advances in preventive and therapeutic strategies, cardiovascular disease (CVD) remains the primary source of death and disability worldwide. 1 Further, the demographic shift towards an older population will result in increasing numbers of patients, among whom heart disease is the leading cause of death. In view of this global burden, personalized risk-stratification tools and a cost-effective management of CVD are urgently needed. Although rapid innovations in atherosclerosis imaging have widened its applications from anatomical plaque detection to physiological assessment and complex evaluation of vascular biology, non-invasive imaging tools that flag the 'vulnerable' patient are still lacking. Indeed, although the presence of coronary artery stenosis is associated with subsequent events, most myocardial infarctions occur in segments with non-obstructive rather than obstructive disease. 2 As recent landmark trials have further highlighted the fundamental role of inflammation during all stages of See related article, https://doi.

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Imaging of heart disease in women: review and case presentation

Mikaïl

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Bengs

et al. 2022

Eur J Nucl Med Mol Imaging

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Cardiovascular diseases (CVD) remain the leading cause of mortality worldwide. Although major diagnostic and therapeutic advances have significantly improved the prognosis of patients with CVD in the past decades, these advances have less benefited women than age-matched men. Noninvasive cardiac imaging plays a key role in the diagnosis of CVD. Despite shared imaging features and strategies between both sexes, there are critical sex disparities that warrant careful consideration, related to the selection of the most suited imaging techniques, to technical limitations, and to specific diseases that are overrepresented in the female population. Taking these sex disparities into consideration holds promise to improve management and alleviate the burden of CVD in women. In this review, we summarize the specific features of cardiac imaging in four of the most common presentations of CVD in the female population including coronary artery disease, heart failure, pregnancy complications, and heart disease in oncology, thereby highlighting contemporary strengths and limitations. We further propose diagnostic algorithms tailored to women that might help in selecting the most appropriate imaging modality.

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Sex-dependent association between inflammation, neural stress responses, and impaired myocardial function

Cited by 21 publications

References 14 publications

Sex and gender aspects in vascular pathophysiology

Sex and gender aspects in vascular pathophysiology

Imaging inflammation in atherosclerosis: Exploring all avenues

Imaging of heart disease in women: review and case presentation

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