Anyone who had a heart: MRI reveals gender gap

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  • Published: Nov 1, 2015
  • Author: David Bradley
  • Channels: MRI Spectroscopy
thumbnail image: Anyone who had a heart: MRI reveals gender gap

Longitudinal vs cross section

As we get older the left ventricle of the heart responds differently in men and women in terms of its mass and volume. For both, there is increased concentric remodelling of this tissue with age but for men men, the opposition of longitudinal and cross-sectional changes as revealed by magnetic resonance imaging (MRI) highlights the importance of longitudinal research into changes in the aging heart.

As we get older the left ventricle of the heart responds differently in men and women in terms of its overall mass and volume and how that changes. For both, there is increased concentric remodelling of this tissue with age but for men, magnetic resonance imaging (MRI) reveals changes with implications for long-term heart health, which highlights the importance of research into changes in the aging heart and using different approaches to study.

John Eng of the Russell H. Morgan Department of Radiology and Radiological Science at Johns Hopkins University School of Medicine, in Bethesda, Maryland and colleagues at the University of Washington, Seattle, UCLA School of Medicine, Los Angeles, California, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, Brigham and Women’s Hospital, Boston, Massachusetts, the National Heart, Lung, and Blood Institute and the National Institutes of Health Clinical Center, both also in Bethesda, Vanderbilt University School of Medicine, Nashville, Tennessee, Columbia University, New York describe details in the journal Radiology, published by the Radiological Society of North America. The MRI study was undertaken with almost 3000 participants, aged 54 to 94 years at follow-up, who had undergone baseline and follow-up cardiac MRI as part of the Multi-Ethnic Study of Atherosclerosis. 53 percent of the 2935 participants were women and the median time between baseline and follow-up MRI was 9.4 years.

Ventricular mass

Left ventricular (LV) mass and geometry are, the team says, independent predictors of events associated with cardiovascular disease. The link is present in people with a previous history of coronary heart disease or heart failure and those without, this much was known. Moreover, there is clinical evidence that treatment to reduce LV mass can reduce the incidence of a cardiovascular event. "These epidemiologic and therapeutic relationships support the role of LV mass as an important subclinical marker for cardiovascular disease," the team says.

As such, they have now found that over the almost-decade long period between baseline and follow-up, LV mass increased in men and decreased slightly in women (8.0 and -1.6 g per decade, respectively), while diastolic volume of the LV decreased in both men and women (-9.8 and -13.3 millilitre per decade, respectively) as did stroke volume (-8.8 and -8.6 millilitres per decade). The mass to volume ratio increased for both men and women (0.14 and 0.11 grams per millilitre per decade). "Change in LV mass was positively associated with systolic blood pressure and body mass index and negatively associated with treated hypertension and high-density lipoprotein cholesterol level," the team reports. "In men, the longitudinal LV mass increase was in contrast to a cross-sectional pattern of LV mass decrease."

Adverse remodelling

The evidence thus suggests that there is adverse "remodelling" of the LV in both men and women but for men in this cohort there is what the team describes as "an effect that operates in a direction opposite of the age effect.” The team concludes that, "These results highlight the importance of longitudinal study and suggest sex-specific differences in age-related cardiac remodelling. Further research is needed to understand the mechanism behind these sex-specific differences."

Related Links

Radiol 2015, online: "Adverse Left Ventricular Remodeling and Age Assessed with Cardiac MR Imaging: The Multi-Ethnic Study of Atherosclerosis"

Article by David Bradley

The views represented in this article are solely those of the author and do not necessarily represent those of John Wiley and Sons, Ltd.

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