Background
Although cardiovascular disease (CVD) is the primary killer of women in the U.S., women and female animals have traditionally been omitted from research studies. In reports that do include both sexes, significant sexual dimorphisms have been demonstrated in development, presentation and outcome of CVD. However, there is little understanding of the mechanisms underlying these observations. A more thorough understanding of sex-specific cardiovascular differences both at baseline and in disease is required to effectively consider and treat all CVD patients.
Methods & Results
We analyzed contractility in the whole rat heart, adult rat ventricular myocytes (ARVMs) and myofibrils from both sexes of rats and observed functional sex differences at all levels. Hearts and ARVMs from female rats displayed greater fractional shortening than males, and female ARVMs and myofibrils took longer to relax. To define factors underlying these functional differences, we performed an RNA-sequencing experiment on ARVMs from male and female rats and identified ~600 genes were expressed in a sexually dimorphic manner. Further analysis revealed sex-specific enrichment of signaling pathways and key regulators. At the protein level, female ARVMs exhibited higher PKA activity, consistent with pathway enrichment identified through RNA-seq. Additionally, activating the PKA pathway diminished the contractile sexual dimorphisms previously observed.
Conclusions
These data support the notion that sex-specific gene expression differences at baseline influence cardiac function, particularly through the PKA pathway, and could potentially be responsible for differences in CVD presentation and outcomes.