EXPLORING HER HEART

Pioneering research may lead to an accurate predictor of heart failure risk in women.

Processes leading to heart failure differ by gender, according to research conducted by Cedars-Sinai investigators. The disparity stems from cellular-level differences in the heart muscle and surrounding tissue caused by fibrosis, according to cardiologist Alan Kwan, MD, lead author of the study, which was published in the journal Heart. ¶ “We have known for some time that, with aging, women’s hearts tend to have a thicker wall, shrink more in size, and pump faster and harder than men's hearts,” Dr. Kwan says. “While these structural differences can be seen with the naked eye, it requires more sensitive and detailed imaging to understand how these changes lead to, or result in, heart failure.”

The discovery was made possible by an innovative cardiacimaging technique devised by study senior author Susan Cheng, MD, MPH, MMSc, director of the Institute for Research on Healthy Aging at the Smidt Heart Institute. The method measures high-spectrum signal-intensity coefficient in cardiac ultrasound images to detect microstructural changes that would otherwise remain invisible.

Using this novel technique, researchers extracted unprecedented levels of data from the ultrasound images of 2,511 adult hearts. The images used were from the National Institutes of Health’s Framingham Offspring Study. “We evaluated whether a measurement of cardiac microstructure could predict heart failure,” says Dr. Cheng, who holds the Erika J. Glazer Chair in Women’s Cardiovascular Health and Population Science.

These microstructural changes, likely the result of greater amounts of fibrosis, predicted future diagnosis of heart failure, especially in women. Dr. Kwan notes that this process may be a key reason why women, as they age, are more likely than men to develop heart failure with preserved ejection fraction (HFpEF).

The team now plans to expand their cardiac-imaging capacity to further elucidate personalized risks of heart disease. Their goal is to develop better diagnostic tools and more precise treatments for HFpEF and other cardiac conditions.