Sex differences in ischemic heart disease and heart failure biomarkers

Castro, Diana K. Nieves; Fu, Qin; Gottlieb, Roberta A.; Eyk, Jennifer E. Van; Merz, C. Noel Bairey

doi:10.1186/s13293-018-0201-y

Cited by 37 publications

(21 citation statements)

References 59 publications

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“…When measured at the same time of the clinical and echocardiographic evaluation of the subjects included in the PREDICTOR cohort, NT-proBNP proved to be higher, irrespective of the presence of HF, in females than in males aged 65+ years. Similar findings in patients/subjects of different ages have been previously reported [ 22 ]. The association of logNT-proBNP with HF and diastolic dysfunction was stronger in men than in women.…”

Section: Discussionsupporting

confidence: 91%

Sex differences in factors associated with heart failure and diastolic left ventricular dysfunction: a cross-sectional population-based study

et al. 2021

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Background Although sex differences in cardiovascular diseases are recognised, including differences in incidence, clinical presentation, response to treatments, and outcomes, most of the practice guidelines are not sex-specific. Heart failure (HF) is a major public health challenge, with high health care expenditures, high prevalence, and poor clinical outcomes. The objective was to analyse the sex-specific association of socio-demographics, life-style factors and health characteristics with the prevalence of HF and diastolic left ventricular dysfunction (DLVD) in a cross-sectional population-based study. Methods A random sample of 2001 65–84 year-olds underwent physical examination, laboratory measurements, including N-terminal pro-B-type natriuretic peptide (NT-proBNP), electrocardiography, and echocardiography. We selected the subjects with no missing values in covariates and echocardiographic parameters and performed a complete case analysis. Sex-specific multivariable logistic regression models were used to identify the factors associated with the prevalence of the diseases, multinomial logistic regression was used to investigate the factors associated to asymptomatic and symptomatic LVD, and spline curves to display the relationship between the conditions and both age and NT-proBNP. Results In 857 men included, there were 66 cases of HF and 408 cases of DLVD (77% not reporting symptoms). In 819 women, there were 51 cases of HF and 382 of DLVD (79% not reporting symptoms). In men, the factors associated with prevalence of HF were age, ischemic heart disease (IHD), and suffering from three or more comorbid conditions. In women, the factors associated with HF were age, lifestyles (smoking and alcohol), BMI, hypertension, and atrial fibrillation. Age and diabetes were associated to asymptomatic DLVD in both genders. NT-proBNP levels were more strongly associated with HF in men than in women. Conclusions There were sex differences in the factors associated with HF. The results suggest that prevention policies should consider the sex-specific impact on cardiac function of modifiable cardiovascular risk factors.

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Section: Discussionsupporting

confidence: 91%

Sex differences in factors associated with heart failure and diastolic left ventricular dysfunction: a cross-sectional population-based study

et al. 2021

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“…However, most of these cardiovascular biomarkers are used day-to-day by clinicians without taking sex into account. It is hypothesized that the lack of sex-specific thresholds for cardiac biomarkers might contribute to underdiagnosing HF in women, which could potentially result in worse outcomes (10).…”

Section: Introductionmentioning

confidence: 99%

Gender-Related Differences in Heart Failure Biomarkers

Cediel

Codina

Spitaleri

et al. 2021

Front. Cardiovasc. Med.

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Important differences in comorbidities and clinical characteristics exist between women and men with heart failure (HF). In particular, differences in the kinetics of biological circulating biomarkers—a critical component of cardiovascular care—are highly relevant. Most circulating HF biomarkers are assessed daily by clinicians without taking sex into account, despite the multiple gender-related differences observed in plasma concentrations. Even in health, compared to men, women tend to exhibit higher levels of natriuretic peptides and galectin-3 and lower levels of cardiac troponins and the cardiac stress marker, soluble ST2. Many biological factors can provide a reliable explanation for these differences, like body composition, fat distribution, or menopausal status. Notwithstanding, these sex-specific differences in biomarker levels do not reflect different pathobiological mechanisms in HF between women and men, and they do not necessarily imply a need to use different diagnostic cut-off levels in clinical practice. To date, the sex-specific prognostic value of HF biomarkers for risk stratification is an unresolved issue that future research must elucidate. This review outlines current evidence regarding gender-related differences in circulating biomarkers widely used in HF, the pathophysiological mechanisms underlying these differences, and their clinical relevance.

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“…Although it is possible that artefacts due to contamination could occur, we found that there was no change in the expression of Ang II, ET-1, and type A, B and C NPs between the papillary tip and other portions of the kidneys. Even though its mechanism remains unknown, we initially evaluated elderly female mice as ageing and the female sex contribute to the expression of BNP in both normal subjects and patients with CHF [131,132,133,134]. However, we observed a similar activation of the BNP promoter in the papillary tips from young adults and/or male adult mice, although this was not recognized in neonatal mice [25].…”

Section: Renal Papillary Tip May Contribute To the Expression Of Bmentioning

confidence: 99%

BNP as a Major Player in the Heart-Kidney Connection

Okamoto

Ali

Hashizume

et al. 2019

IJMS

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Brain natriuretic peptide (BNP) is an important biomarker for patients with heart failure, hypertension and cardiac hypertrophy. Although it is known that BNP levels are relatively higher in patients with chronic kidney disease and no heart disease, the mechanism remains unknown. Here, we review the functions and the roles of BNP in the heart-kidney interaction. In addition, we discuss the relevant molecular mechanisms that suggest BNP is protective against chronic kidney diseases and heart failure, especially in terms of the counterparts of the renin-angiotensin-aldosterone system (RAAS). The renal medulla has been reported to express depressor substances. The extract of the papillary tips from kidneys may induce the expression and secretion of BNP from cardiomyocytes. A better understanding of these processes will help accelerate pharmacological treatments for heart-kidney disease.

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Sex differences in ischemic heart disease and heart failure biomarkers

Cited by 37 publications

References 59 publications

Sex differences in factors associated with heart failure and diastolic left ventricular dysfunction: a cross-sectional population-based study

Sex differences in factors associated with heart failure and diastolic left ventricular dysfunction: a cross-sectional population-based study

Gender-Related Differences in Heart Failure Biomarkers

BNP as a Major Player in the Heart-Kidney Connection

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