Gender specific pattern of left ventricular cardiac adaptation to hypertension and obesity in a tertiary health facility in Nigeria

Abstract Coronary fistulas are rare, not gender-specific congenital conditions, consisting of communications between the coronary arteries and either another coronary vessel or a cardiac chamber. In contrast to large fistulas, small fistulas, named “minimae cordis veneae” or the Thebesius venous system, are draining into heart chambers and form a vascular network in the cardiac lumen. In this article, we present the case of a 72-year-old female with a significant history of cardiovascular disease, admitted to our clinic because of rest dyspnea, fatigue, and minimal chest pain. The 12-lead electrocardiogram showed a trifascicular block (a second-degree atrioventricular block Mobitz II, associated with a right bundle branch block and left anterior fascicle block) and negative T waves in DII, DIII, aVF, V4–V6 leads. An invasive coronary angiography was performed, which revealed no significant atherosclerotic lesions. However, a persistent capillary blush was present at the apex site of the left ventricular chamber, draining from the distal segments of both the anterior descending coronary artery and the posterior interventricular coronary artery. The intramural vascular network generating a left ventricle angiogram image of this kind was suggestive for persistent Thebesian vessels connecting the two coronaries with the left ventricular chamber.

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Gender-specific genital and subjective sexual arousal to prepotent sexual stimuli in androphilic men and gynephilic women

The Canadian Journal of Human Sexuality ◽

10.3138/cjhs.2021-0004 ◽

2021 ◽

pp. e20210004

Author(s):

Nina Micanovic ◽

Amanda D. Timmers ◽

Meredith L. Chivers

Keyword(s):

Sexual Arousal ◽

Specific Pattern ◽

Sexual Response ◽

Sex Characteristics ◽

Complex Nature ◽

Specific Response ◽

Response Patterns ◽

Sexual Stimuli ◽

Subjective Sexual Arousal ◽

Gender Specific

Marked differences have been found in men’s and women’s sexual response patterns, contingent upon their sexual orientation; androphilic (attracted to men) and gynephilic (attracted to women) men demonstrate greatest genital and self-reported arousal to their preferred stimulus type (a “gender-specific” response), whereas androphilic women do not, and findings for gynephilic women have been mixed. While there have been many investigations into gynephilic men’s and androphilic women’s (i.e., heterosexual men/women) sexual response, there has been less investigation into the specificity of sexual response of androphilic men and gynephilic women. Given the complex nature of sexual stimuli that are used in sexual response research, it is often unclear to what extent contextual cues (e.g., cues other than the sexual actor’s primary and secondary sex characteristics, such as physical attractiveness, sexual activity, etc.) influence participants’ sexual response patterns. As such, the current study examined genital, discrete self-reported, and continuous self-reported responses of androphilic men ( n = 22) and gynephilic women ( n = 10) to prepotent sexual features (stimuli thought to elicit automatic sexual arousal: erect penises and exposed vulvas), non-prepotent sexual features (flaccid penises and pubic triangles) and neutral stimuli (clothed men and women). Both samples exhibited a gender-specific pattern of genital, self-reported, and continuous self-reported sexual arousal. Similarly, all measures of sexual arousal were generally found to be greatest to “prepotent” sexual cues. Implications for understanding gender specificity of sexual response are discussed.

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Gender-specific risk of complications in catheter ablation for atrial fibrillation

European Heart Journal ◽

10.1093/ehjci/ehaa946.0591 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

J Plasek ◽

P Peichl ◽

D Wichterle ◽

R Cihak ◽

...

Keyword(s):

Risk Factors ◽

Atrial Fibrillation ◽

Catheter Ablation ◽

Body Height ◽

Left Ventricular ◽

Navigation Systems ◽

3D Navigation ◽

Bundle Branch Block ◽

Specific Risk ◽

Gender Specific

Abstract Background Catheter ablation is an established treatment modality for atrial fibrillation (AF). The risk of procedural complications is not negligible. Some studies suggested that female patients have a higher risk of complications. Purpose To identify gender-specific predictors of major complications (MCs) in patients undergoing catheter ablation for AF in a tertiary ablation centre. Methods A total of 4733 catheter ablations for AF (65% paroxysmal, 26% repeated procedures) were performed at our centre between January 2006 and August 2018. Patients (71% males) aged 60±10 years and had body mass index of 29±4 kg/m2 at the time of the procedure. Radiofrequency point-by-point ablation was employed in 96.3% procedures with the use of 3D navigation systems and facilitated by intracardiac echocardiography. Pulmonary vein isolation was mandatory; cavotricuspid isthmus and left atrial substrate ablation were performed in 22% and 38% procedures, respectively. MCs were defined as those that resulted in permanent injury, required intervention or prolonged hospitalization. Variables were assessed by uni- and multivariate analysis, two-sided α<0.05 was considered significant. Results A total of 160 (3.4%) MCs were detected - 60 (4.4%) in females and 100 (2.9%) in males (P=0.012). Both lower body height and the presence of bundle branch block (BBB) were associated with MCs only in females; for left bundle branch block (LBBB), the effect size was higher. On the contrary, higher left ventricular end-diastolic diameter (LVEDd) and persistent AF were associated with MCs in males (Table). Conclusion Females have a higher risk of MCs during catheter ablation for AF. Body height, AF type, BBB, and LVEDd may belong among gender-specific risk factors for MCs in AF ablation procedures. Whether BBB and LVEDd represent true risk factors warrants a validation in further studies. Funding Acknowledgement Type of funding source: None

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TWO-DIMENSIONAL ECHOCARDIOGRAPHIC CHARACTERISTICS IN PRE-ADOLESCENT ATHLETES

Inter Collegas ◽

10.35339/ic.3.3.138-141 ◽

2016 ◽

Vol 3 (3) ◽

pp. 138-141

Author(s):

O. Onikiienko

Keyword(s):

Left Ventricular ◽

Left Ventricular Ejection ◽

Myocardial Remodeling ◽

Two Dimensional ◽

Ventricular Ejection Fraction ◽

Cardiac Adaptation ◽

Group 3 ◽

Group 2 ◽

Sports Activities ◽

Group 1

Data of echocardiographic characteristics of 59 children 10-11 years old, involved in football is presented in article. Depending on the duration of sports activities the children were divided into 3 groups: group 1 - children who play football up to 3 years (24 children), Group 2 - children who play football from 3 to 5 years (23 children), Group 3 - training duration over 5 years (12 children). It was found that the linear sizes of the heart were not significantly different in the groups studied, which may indicate that myocardial remodeling as cardiac adaptation to sporting loads takes more time. It was revealed that more trained children (group 3) have significantly higher left ventricular ejection fraction compared with group 1 (p = 0.05) and Group 2 (p = 0.0051). Keywords: athletes, children, echocardiography РезюмеО. ОникиенкоДвумерные эхокардиографические характеристики препубертатных спортсменов В статье приведены результаты ультразвукового обследования 59 детей 10-11 лет, занимающихся футболом. В зависимости от длительности занятий спортом дети были разделены на 3 группы: группа 1 – дети со стажем до 3 лет (24 ребенка), группа 2 - стаж занятий от 3 до 5 лет (23 ребенка), группа 3 – стаж занятий более 5 лет (12 детей). Установлено, что линейные размеры сердца достоверно не отличались в группах обследованных, что может свидетельствовать о более длительном процессе ремоделирования миокарда как адаптации сердца к спортивным нагрузкам. Выявлено, что у более тренированных детей (группа 3) достоверно выше фракция выброса левого желудочка по сравнению с группой 1 (p = 0.05) и с группой 2 (p = 0.0051). Ключевые слова: спортсмены, дети, эхокардиография РезюмеО. ОнікієнкоДвовимірні ехокардіографічні характеристики препубертатних спортсменівУ статті наведено результати ультразвукового обстеження 59 дітей 10-11 років, які займаються футболом. Залежно від тривалості занять спортом діти були розділені на 3 групи: група 1 - діти зі стажем до 3 років (24 дитини), група 2 - стаж занять від 3 до 5 років (23 дитини), група 3 - стаж занять більше 5 років (12 дітей). Встановлено, що лінійні розміри серця достовірно не відрізнялися в групах обстежених, що може свідчити про більшу тривалість ремоделювання міокарда як адаптації серця до спортивних навантажень. Виявлено, що у більш тренованих дітей (група 3) достовірно вища фракція викиду лівого шлуночка в порівнянні з групою 1 (p = 0.05) і з групою 2 (p = 0.0051). Ключові слова: спортсмени, діти, ехокардіографія

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Abstract 16383: Inhibition of Egfr Signalling Promotes Maladaptive Cardiac Remodelling in Hypertensive Heart Disease

Circulation ◽

10.1161/circ.142.suppl_3.16383 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Susanna Cooper ◽

Zoe Haines ◽

Viridiana Alcantara Alonso ◽

Joshua J Cull ◽

Feroz Ahmad ◽

...

Keyword(s):

Heart Failure ◽

Mrna Expression ◽

Left Ventricular ◽

Egfr Inhibitors ◽

Neonatal Rat ◽

Cardiomyocyte Hypertrophy ◽

Rat Cardiomyocytes ◽

Egfr Ligands ◽

Cardiac Adaptation

Introduction: Epidermal growth factor (EGF) receptors (EGFRs: ERBB1-4) are activated by a family of ligands (e.g. EGF, Hb-EGF, EREG, TGFa), signaling through ERK1/2 and Akt to promote cell division and cancer. Antibody-based inhibition of ERBB2 in breast cancer can cause heart failure, but the role of other receptors and EGFR ligands in the heart, and potential cardiotoxicity of generic EGFR inhibitors is unclear. Hypothesis: We hypothesize that EGFR ligands play an important role in cardiac adaptation to hypertension, acting through EGFRs to promote adaptive remodelling. Methods & Results: EGF ligand/receptor mRNA expression was assessed in human failing hearts and normal controls (n=12/8). EGFRs were expressed at similar levels, but ligand expression differed with significant up- or downregulation of EGF/Hb-EGF vs EREG/TGFa, respectively, in failing hearts (p<0.05). EGF potently activated ERK1/2 and Akt (assessed by immunoblotting) in neonatal rat cardiomyocytes, leading to hypertrophy (p<0.05, n=4). The anti-cancer drug afatinib inhibits EGFRs. To assess the role of EGF signaling in cardiac adaptation to hypertension in vivo , C57Bl/6J mice (n=6) were treated with 0.8 mg/kg/d angiotensin II (AngII; 7d) ± 0.45 mg/kg/d afatinib. AngII promoted cardiac hypertrophy with increased left ventricular (LV) wall thickness (WT) and decreased LV internal diameter (ID; assessed by echocardiography). Afatinib enhanced AngII-induced hypertrophy with significantly increased WT:ID ratios (1.30-fold and 1.54-fold in diastole and systole, respectively; p<0.05) but inhibited AngII-induced increases in Nppb mRNA expression and cardiomyocyte cross-sectional area (208.80±9.78 vs 161.10±3.87μm 2 ; p<0.05). In contrast, Col1a1 mRNA expression was enhanced by afatinib, along with interstitial and perivascular fibrosis (3.21±0.38 vs 5.61±0.46, 0.98±0.06 vs 1.45±0.18 % area; p<0.05). Conclusion: EGFR signaling is modulated in human heart failure, promotes cardiomyocyte hypertrophy and is required for cardiac adaptation to hypertension. Since EGFR inhibition in hypertension prevents adaptive cardiomyocyte hypertrophy whilst promoting fibrosis, EGFR inhibitors are likely to cause cardiac dysfunction and be cardiotoxic in hypertensive patients.

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Sex-specific pattern of left ventricular hypertrophy and diastolic function in patients with type 2 diabetes mellitus

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jeaa079 ◽

2020 ◽

Author(s):

Mei-Zhen Wu ◽

Yan Chen ◽

Yu-Juan Yu ◽

Zhe Zhen ◽

Ying-Xian Liu ◽

...

Keyword(s):

Myocardial Infarction ◽

Heart Failure ◽

Type 2 Diabetes ◽

Diastolic Dysfunction ◽

Diastolic Function ◽

Cardiovascular Death ◽

Left Ventricular ◽

Specific Pattern

Abstract Aims Few prospective studies have evaluated sex-specific pattern, natural progression of left ventricular (LV) remodelling, and diastolic dysfunction in patients with type 2 diabetes (T2DM). The aim of this study was to study the sex-specific prevalence, longitudinal changes of LV remodelling, and diastolic dysfunction in patients with T2DM. Further, the prognostic value of diastolic function in women and men was also evaluated. Methods and results A total of 350 patients with T2DM (mean age 61 ± 11 years; women, 48.3%) was recruited. Detailed echocardiography was performed at baseline and after 25 months. A major adverse cardiovascular event (MACE) was defined as cardiovascular death, heart failure hospitalization, or myocardial infarction. Despite a similar age, prevalence of hypertension and body mass index, women had a higher prevalence of LV hypertrophy and diastolic dysfunction at baseline and follow-up compared with men. A total of 21 patients developed MACE (5 cardiovascular death, 9 hospitalization for heart failure, and 7 myocardial infarction) during a median follow-up of 56 months. Women with diastolic dysfunction had a higher incidence of MACE than those with normal diastolic function but this association was neutral in men. Multivariable Cox-regression analysis indicated that diastolic dysfunction was associated with MACE in women [hazard ratio = 6.30; 95% confidence interval (CI) = 1.06–37.54; P < 0.05] but not men (hazard ratio = 2.29, 95% CI = 0.67–7.89; P = 0.19). Conclusion LV hypertrophy and diastolic dysfunction, both at baseline and follow-up, were more common in women than men. Pre-clinical diastolic dysfunction was independently associated with MACE only in women with T2DM but was neutral in men.

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The indirect effect of bullying on adolescent self-rated health through mental health: A gender specific pattern

Children and Youth Services Review ◽

10.1016/j.childyouth.2019.104385 ◽

2019 ◽

Vol 104 ◽

pp. 104385

Author(s):

Anao Zhang ◽

Chun Liu ◽

Lindsay A. Bornheimer ◽

Phyllis Solomon ◽

Kaipeng Wang ◽

...

Keyword(s):

Mental Health ◽

Indirect Effect ◽

Specific Pattern ◽

Self Rated Health ◽

Gender Specific

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P819 Outflow graft twist occlusion in the heartmate 3 left ventricular assist system in 7 cases: analysis of potential mechanisms using computed tomography

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jez319.471 ◽

2020 ◽

Vol 21 (Supplement_1) ◽

Author(s):

N Solowjowa ◽

D Zimpfer ◽

M Mueller ◽

H Krastev ◽

V Falk ◽

...

Keyword(s):

Computed Tomography ◽

Aortic Valve ◽

Left Ventricular ◽

Specific Pattern ◽

Implantation Technique ◽

Ventricular Assist ◽

Inflow Cannula ◽

Valve Opening ◽

Outflow Channel ◽

Outflow Graft

Abstract Background Twist of the outflow graft (OG) of the HeartMate 3 left ventricular (LV) assist device (HM3) with subsequent occlusion is a rare, but life-threatening complication. Purpose We evaluated if potential implantation technique dependent mechanisms of OG twist can be predicted by multislice computed tomography (MSCT). Methods We retrospectively analyzed clinical, echocardiographic and MSCT data of 7 patients with angiographically proven and surgically corrected OG twist and of 11 consecutive patients without any type of pump obstruction. MSCT parameters were: position of inflow cannula related to anatomical LV apex (1), angulation of axis of inflow cannula related to LV axis (2), orientation of outflow channel of the pump housing related to LV axis (3), OG course (4). Echocardiographic parameters were LV end-diastolic diameter (LVEDD) and aortic valve opening. Results Mean time from implantation to twist was 563 ± 161 days. Preoperative LVEDD (64.6 ± 9.8 mm vs. 67.4 ± 10.2 mm, p = 0.563) was similar. LVEDD reduction after implantation (20% vs. 28%) and prevalence of aortic valve opening was higher in the twist group (71% vs. 45%). The MSCT measurements showed a high degree of heterogeneity in both groups: (1) differed from superior to infero-lateral; (2) varied from cranial to caudal, lateral and medial; (3) varied from antero-septal to inferior. (4) showed an incidence of non-obstructive kinking of 29% and 36%, respectively. Conclusion Marked heterogeneity of the measured MSCT parameters was observed in both groups. No specific pattern or geometric relation could be attributed to the OG twist phenomenon.

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Cardiac adaptation of sarcomere dynamics to arterial load: a model of hypertrophy

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.1992.263.4.h1054 ◽

1992 ◽

Vol 263 (4) ◽

pp. H1054-H1063 ◽

Cited By ~ 2

Author(s):

G. M. Drzewiecki ◽

E. Karam ◽

J. K. Li ◽

A. Noordergraaf

Keyword(s):

Left Ventricle ◽

Element Model ◽

Left Ventricular ◽

Arterial System ◽

Optimal Point ◽

The Past ◽

Cardiac Adaptation ◽

Arterial Load ◽

Myocardial O2 Consumption ◽

Physiological Hypertrophy

In the past, the dynamics of the left ventricle were studied by its response to altered venous and arterial load for a given heart. This led researchers to propose the concept of an arterioventricular match or optimal point of function. The model of this paper reverses that idea by fixing preload and afterload while computing cardiac function due to altered left ventricular size or shape, resulting from modification of the number of parallel and series sarcounits. A mathematical model of physiological hypertrophy is introduced. Series and parallel arrangements of sarcounits constitute a cylindrical model of the left ventricle. Filling occurs from a venous reservoir with constant pressure through a valve, while ejection takes place into a three-element model of the systemic arterial system through another valve. It is found that the dynamics of the myofibrils can be matched to those of the left ventricle by choosing a ventricular shape that results in a minimum in myocardial O2 consumption (MVO2) for any constant ventricular load. A unique solution for the size of the ventricle results if the rate of MVO2 is specified. The model is able to predict correctly hypertrophy due to hypoxia and due to pressure (concentric) and volume (eccentric) overloads.

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Gender-specific patterns of left ventricular and myocyte remodeling following myocardial infarction in mice deficient in the angiotensin II type 1a receptor

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.00474.2004 ◽

2005 ◽

Vol 289 (2) ◽

pp. H586-H592 ◽

Cited By ~ 25

Author(s):

Paul Bridgman ◽

Mark A. Aronovitz ◽

Rahul Kakkar ◽

Michael I. Oliverio ◽

Thomas M. Coffman ◽

...

Keyword(s):

Gene Expression ◽

Myocardial Infarction ◽

Infarct Size ◽

Left Ventricular ◽

Wild Type ◽

Lower Systolic Blood Pressure ◽

Male And Female ◽

Myocyte Hypertrophy ◽

Lv Mass ◽

Gender Specific

Left ventricular (LV) remodeling after myocardial infarction (MI) results from hypertrophy of myocytes and activation of fibroblasts induced, in part, by ligand stimulation of the ANG II type 1 receptor (AT1R). The purpose of the present study was to explore the specific role for activation of the AT1aR subtype in post-MI remodeling and whether gender differences exist in the patterns of remodeling in wild-type and AT1aR knockout (KO) mice. AT1aR-KO mice and wild-type littermates underwent coronary ligation to induce MI or sham procedures; echocardiography and hemodynamic evaluation were performed 6 wk later, and LV tissue was harvested for infarct size determination, morphometric measurements, and gene expression analysis. Survival and infarct size were similar among all male and female wild-type and AT1aR-KO mice. Hemodynamic indexes were also similar except for lower systolic blood pressure in the AT1aR-KO mice compared with wild-type mice. Male and female wild-type and male AT1aR-KO mice developed similar increases in LV chamber size, LV mass corrected for body weight (LV/BW), and myocyte cross-sectional area (CSA). However, female AT1aR-KO mice demonstrated no increase in LV/BW and myocyte CSA post-MI compared with shams. Both male and female wild-type mice demonstrated higher atrial natriuretic peptide (ANP) levels after MI, with female wild types being significantly greater than males. However, male and female AT1aR-KO mice developed no increase in ANP gene expression with MI despite an increase in LV mass and myocyte size in males. These data support that gender-specific patterns of LV and myocyte hypertrophy exist after MI in mice with a disrupted AT1aR gene, and suggest that myocyte hypertrophy post-MI in females relies, in part, on activation of the AT1aR. Further work is necessary to explore the potential mechanisms underlying these gender-based differences.

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