Skip to main content

Advertisement

Log in

Hypertrophy in the female heart

  • Published:
Current Cardiology Reports Aims and scope Submit manuscript

Abstract

Several clinical studies have suggested that sex influences the left ventricle’s response to altered loading conditions and thus the development of cardiac hypertrophy. Likewise, several of the risk factors associated with the development of hypertrophy exhibit sexual dimorphism in their distribution in the general population. These sex-specific differences in risk factor distribution are likely important modifiers in disease progression and outcome. This review explores the available evidence of sex-specific differences in the evolution of left ventricular hypertrophy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References and Recommended Reading

  1. Levy D, Garrison RJ, Savage DD, et al.: Prognostic implications of echocardiographically determined left ventricular mass in the Framingham study. N Engl J Med 1990, 322:1561–1566.

    Article  PubMed  CAS  Google Scholar 

  2. Izzo JL, Gradman AH: Mechanisms and management of hypertensive heart disease: from left ventricular hypertrophy to heart failure. Med Clin North Am 2004, 88:1257–1271.

    Article  PubMed  Google Scholar 

  3. Ho K, Anderson KM, Kannel WB, et al.: Survival after the onset of congestive heart failure in Framingham heart study subjects. Circulation 1993, 88:107–115. Classic article from Framingham study.

    PubMed  CAS  Google Scholar 

  4. Ho K, Pinsky JL, Kannel WB, et al.: The epidemiology of heart failure: the Framingham study. J Am Coll Cardiol 1993, 22(Suppl A):6A-13A. Classic article from Framingham study.

    Article  PubMed  CAS  Google Scholar 

  5. Stone P, Muller JE, Hartwell T, et al.: The effect of diabetes mellitus on prognosis and serial left ventricular function after acute myocardial infarction: contribution of both coronary disease and diastolic left ventricular dysfunction to the adverse prognosis. J Am Coll Cardiol 1989, 14:49–57.

    Article  PubMed  CAS  Google Scholar 

  6. Lloyd-Jones DM, Larson MG, Leip EP, et al.: Lifetime risk for developing congestive heart failure: the Framingham heart study. Circulation 2002, 106:3068–3072.

    Article  PubMed  Google Scholar 

  7. Lindenfeld J, Krause-Steinrauf H, Salerno J: Where are all the women with heart failure? J Am Coll Cardiol 1997, 30:1417–1419.

    Article  PubMed  CAS  Google Scholar 

  8. Masoudi FA, Havranek EP, Smith G, et al.: Gender, age and heart failure with preserved left ventricular systolic function. J Am Coll Cardiol 2003, 41:217–223. Important article, large study showing the prevalence of diastolic heart failure in women.

    Article  PubMed  Google Scholar 

  9. Burt VL, Whelton P, Rocella EJ, et al.: Prevalence of hypertension in the US adult population. Results from the third national health and nutrition examination survey, 1988–1991. Hypertension 1995, 25:305–313.

    PubMed  CAS  Google Scholar 

  10. Mosca L, Manson JE, Sutherland SE, et al.: Cardiovascular disease in women: a statement for healthcare professionals from the American Heart Association writing group. Circulation 1997, 96:2468–2482.

    PubMed  CAS  Google Scholar 

  11. Mosca L, Grundy SM, Judelson D, et al.: Guide to preventive cardiology for women. AHA/ACC scientific statement consensus panel statement. Circulation 1999, 99:2480–2484.

    PubMed  CAS  Google Scholar 

  12. Wenger NK: Clinical characteristics of coronary heart disease in women: emphasis on gender differences. Cardiovasc Res 2000, 53:558–567. Nice comprehensive review of the most common cardiovascular disease in women, and diagnostic and treatment differences.

    Article  Google Scholar 

  13. Liao Y, Cooper RS, Mensah GA, et al.: Left ventricular hypertrophy has a greater impact on survival in women than in men. Circulation 1995, 92:805–810. Classic study showing the survival difference between men and women with LVH. Interestingly, cohort of black women.

    PubMed  CAS  Google Scholar 

  14. Schillaci G, Verdecchia P, Porcellati C, et al.: Continuous relation between left ventricular mass and cardiovascular risk in essential hypertension. Hypertension 2000, 35:580–586.

    PubMed  CAS  Google Scholar 

  15. American Heart Association: 2004 Heart and Stroke Statistical Update. Dallas: American Heart Association; 2004.

    Google Scholar 

  16. Tofler GH, Stone P, Muller JE, et al.: Effects of gender and race on prognosis after myocardial infarction: adverse prognosis for women, particularly black women. J Am Coll Cardiol 1987, 9:473–482.

    Article  PubMed  CAS  Google Scholar 

  17. Abbott RD, Donahue RP, Kannel WB, et al.: The impact of diabetes on survival following myocardial infarction in men vs. women. the Framingham study. JAMA 1988, 260:3456–3460.

    Article  PubMed  CAS  Google Scholar 

  18. UKPDS Working Group: The United Kingdom Prospective Diabetes Study. BMJ 1998, 317:703–713. Important prospective clinical trial on the impact of hyperglycemia on outcomes in diabetics.

    Google Scholar 

  19. Shindler D, Kostis JB, Yusuf S, et al.: Diabetes mellitus, a predictor of morbidity and mortality in the studies of left ventricular dysfunction (SOLVD) trials and registry. Am J Cardiol 1996, 77:1017–1020.

    Article  PubMed  CAS  Google Scholar 

  20. Adams K, Dunlap SH, Sueta CA, et al.: Relation between gender, etiology and survival in patients with symptomatic heart failure. J Am Coll Cardiol 1996, 28:1781–1788.

    Article  PubMed  Google Scholar 

  21. Adams KF, Sueta CA, Gheorghiade M, et al.: Gender differences in survival in advanced heart failure. insights from the FIRST study. Circulation 1999, 99:1816–1821. Both articles by Adams et al. [20,21 ] are important as they are among the first studies to show sex-specific differences in disease outcome by etiology of heart failure.

    PubMed  Google Scholar 

  22. deSimoneG, Devereux RB, Daniels SR, et al.: Gender differences in left ventricular growth. Hypertension 1995, 26:979–983.

    PubMed  Google Scholar 

  23. Walsh RA: Molecular and cellular biology of the normal, hypertrophied and failing heart. In Hurst: The Heart. Edited by Fuster V, Alexander RW, O’Rourke RA. New York: McGraw Hill; 2004:125–131.

    Google Scholar 

  24. Quaini F, Urbanek K, Graiani G, et al.: The regenerative potential of the human heart. Int J Cardiol 2004, 95(Suppl 1):S26-S28. Nice short review on a new area that will likely be important in developing stem cell-based therapies for heart failure.

    Article  PubMed  Google Scholar 

  25. Schiable T, Malhotra A, Ciambrone G, et al.: The effects of gonadectomy on left ventricular function and contractile proteins in males and female rats. Circ Res 1984, 54:38–49. Classic article on hormonal influences in LV function.

    Google Scholar 

  26. Cabral AV, Vasquez EC, Moyes MR, et al.: Sex hormone modulation of ventricular hypertrophy in sinoaortic denervated rats. Hypertension 1988, 11(Suppl I):I93-I97.

    PubMed  CAS  Google Scholar 

  27. Aurigemma G, Silver KH, McLauglin M, et al.: Impact of chamber geometry and gender on left ventricular systolic function in patients> 60 years of age with aortic stenosis. Am J Cardiol 1994, 74:794–798.

    Article  PubMed  CAS  Google Scholar 

  28. Aurigemma G, Gaasch WH: Gender differences in older patients with pressure overload hypertrophy of the left ventricle. Cardiology 1995, 86:310–317.

    Article  PubMed  CAS  Google Scholar 

  29. Carroll J, Carroll EP, Feldman T, et al.: Sex-associated differences in left ventricular function in aortic stenosis of the elderly. Circulation 1992, 86:1099–1107. Classic articles describing clinical observations of LV remodeling difference in patients with aortic stenosis by sex.

    PubMed  CAS  Google Scholar 

  30. Luchner A, Brockel U, Muscholl M, et al.: Gender-specific differences of cardiac remodeling in subjects with left ventricular dysfunction: a population-based study. Cardiovasc Res 2002, 53:720–727.

    Article  PubMed  CAS  Google Scholar 

  31. Crabbe DL, Dipla K, Ambati S, et al.: Gender difference in post infarction hypertrophy in end-stage failing hearts. J Am Coll Cardiol 2003, 41:300–306.

    Article  PubMed  Google Scholar 

  32. Douglas PS, Katz SE, Weinberg EO, et al.: Hypertrophic remodeling: gender differences in the early response to left ventricular pressure overload. J Am Coll Cardiol 1998, 32:1118–1125.

    Article  PubMed  CAS  Google Scholar 

  33. Weinberg EO, Thienelt CD, Katz SE, et al.: Gender differences in molecular remodeling in pressure overload hypertrophy. J Am Coll Cardiol 1999, 34:264–273. Among the first to describe differences in the progression of LV and molecular remodeling by sex. Classic article.

    Article  PubMed  CAS  Google Scholar 

  34. Sharkey LC, Holycross BJ, Park S, et al.: Effect of ovariectomy and estrogen replacement on cardiovascular disease in heart failure-prone SHHF/Mcc-fa cp rats. J Mol Cell Cardiol 1999, 31:1527–1537.

    Article  PubMed  CAS  Google Scholar 

  35. van Eickels M, Grohe C, Cleutjens JP, et al.: 17beta-estradiol attenuates the development of pressure-overload hypertrophy. Circulation 2001, 104:1419–1423.

    PubMed  Google Scholar 

  36. Mendelsohn ME: Mechanisms of estrogen action in the cardiovascular system. J Steroid Biochem Mol Biol 2000, 74:337–343.

    Article  PubMed  CAS  Google Scholar 

  37. Hulley S, Grady D, Bush T, et al.: Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women. Heart and Estrogen/ progestin Replacement Study (HERS) Research Group. JAMA 1998, 280:605–613.

    Article  PubMed  CAS  Google Scholar 

  38. Grady D, Herrington D, Bittner V, et al.: Cardiovascular disease outcomes during 6.8 years of hormone therapy: Heart and Estrogen/Progestin Replacement Study follow-up (HERS II). JAMA 2002, 288:49–57.

    Article  PubMed  Google Scholar 

  39. Women’s Health Initiative Working Group: Risks and benefits of estrogen plus progestin in healthy postmenopausal women. JAMA 2002, 288:321–333. These three articles [37,38,39 ] are landmark studies in women’s health. They are the first large randomized clinical trials on hormone therapy in women.

    Article  Google Scholar 

  40. Grundy SM, Hansen B, Smith S C, et al.: Clinical management of metabolic syndrome: report of the American Heart Association/ National Heart, Lung, and Blood Institute/American Diabetes Association conference on scientific issues related to management. Circulation 2004, 109:551–556.

    Article  PubMed  Google Scholar 

  41. Grundy SM, Brewer HB, Cleeman JI, et al.: Definition of metabolic syndrome: report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation 2004, 109:433–438. Nice review of the metabolic syndrome and current treatment recommendations.

    Article  PubMed  Google Scholar 

  42. Ford ES, Giles WH, Dietz WH: Prevalence of the metabolic syndrome among US adults. JAMA 2002, 287:356–359.

    Article  PubMed  Google Scholar 

  43. Park Y, Shankuan Z, Palaniappan L et al.: The metabolic syndrome: prevalence and associated risk factor findings in the US population from the third national health and nutrition examination survey, 1988-1994. Arch Intern Med 2003, 163:427–446.

    Article  PubMed  Google Scholar 

  44. Ford ES: The metabolic syndrome and mortality from cardiovascular disease and all-causes: findings from the national health and nutrition examination survey II mortality study. Atherosclerosis 2004, 173:309–314.

    Article  PubMed  CAS  Google Scholar 

  45. American Heart Association/American College of Cardiology Guidelines for the evaluation and management of congestive heart failure in adults. http:/www.americanheart.org/presenter. jtm1

  46. Rutter MK, Parise H, Benjamin EJ, et al.: Impact of glucose intolerance and insulin resistance on cardiac structure and function: sex-related differences in the Framingham Heart Study. Circulation 2003, 107:448–454.

    Article  PubMed  CAS  Google Scholar 

  47. Sundstrom J, Sullivan L, Selhub J: Relations of plasma homocysteine to left ventricular structure and function: the Framingham Heart Study. Eur Heart J 2004, 25:523–530.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Crabbe, D.L., Harris, N.K. Hypertrophy in the female heart. Curr Cardiol Rep 7, 173–177 (2005). https://doi.org/10.1007/s11886-005-0073-8

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11886-005-0073-8

Keywords

Navigation