Abstract
BackgroundSexual dimorphism in cardiac sympathetic outflow has recently gained attention in the context of Takotsubo cardiomyopathy. Previous studies suggest that there are sex- and age-dependent differences in peripheral autonomic control, however, data on cardiac-specific sympathetic activation in aged women and men are lacking.Methods and resultsRegional quantitative analysis of cardiac fluorine-18 (18F)- Dihydroxyphenylalanine (DOPA) uptake was retrospectively performed in 133 patients (69 females, mean age 52.4±17.7 years) referred for assessment of neuroendocrine tumours (NET) by Positron-Emission-Tomography. Cardiac 18F-DOPA uptake was significantly higher in women as compared to men (1.33±0.21 vs. 1.18±0.24, p<0.001). This sex-difference was most pronounced in the apical region of the left ventricle (LV, 1.30±0.24 in women vs. 1.13±0.25 in men, p<0.001) and in individuals >55 years of age (1.39±0.25 in women vs. 1.09±0.24 in men, p<0.001). Women showed a prominent increase in myocardial 18F-DOPA uptake with age with the strongest increase seen in the LV apical region (r = 0.34, p = 0.004). Accordingly, sex and age were selected as significant predictors of LV apical 18F-DOPA uptake in a stepwise linear regression model. No age-dependent changes of cardiac 18F-DOPA uptake were observed in men or in the right ventricular region.ConclusionOur study suggests that aging is related to sex-specific changes in regional cardiac sympathetic activity. Future studies will have to assess whether the increase in LV apical 18F-DOPA uptake with age in women is of pathogenic relevance for the higher susceptibility of postmenopausal women to conditions associated with increased sympathetic activity.
Highlights
Cardiovascular disease is the leading cause of death and disease burden in both, women and men, in the western world
Our study suggests that aging is related to sex-specific changes in regional cardiac sympathetic activity
Regional quantitative analysis of cardiac 18F-DOPA uptake was performed in reconstructed PET/CT images of all 133 patients
Summary
Cardiovascular disease is the leading cause of death and disease burden in both, women and men, in the western world. Sexual dimorphism in cardiac sympathetic outflow has recently gained increasing attention in the context of Takotsubo cardiomyopathy or cardiac syndrome X.[3,4,5,6] The worse outcomes observed in women with cardiovascular disease as well as their higher susceptibility to cardiac injury during high-stress situations implies that sex-differences in autonomous nervous control of the cardiovascular system might be pathogenetic.[7, 8] there is a lack of data on sex- and age-specific cardiac sympathetic activity in normal individuals and very little information about regional norepinephrine turnover, uptake, and metabolism in the human myocardium is available in the literature. Previous studies suggest that there are sex- and agedependent differences in peripheral autonomic control, data on cardiac-specific sympathetic activation in aged women and men are lacking
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
