Department of Clinical Physiology, Karolinska University Hospital, and Karolinska Institutet, Stockholm, Sweden.
Department of Radiology, Karolinska University Hospital, and Karolinska Institutet, Stockholm, Sweden.
Sci Rep. 2020 Jun 25;10(1):10380. doi: 10.1038/s41598-020-67196-y.
Knowledge on sex differences in myocardial perfusion, blood volume (MBV), and extracellular volume (ECV) in healthy individuals is scarce and conflicting. Therefore, this was investigated quantitatively by cardiovascular magnetic resonance (CMR). Healthy volunteers (n = 41, 51% female) underwent CMR at 1.5 T. Quantitative MBV [%] and perfusion [ml/min/g] maps were acquired during adenosine stress and at rest following an intravenous contrast bolus (0.05 mmol/kg, gadobutrol). Native T1 maps were acquired before and during adenosine stress, and after contrast (0.2 mmol/kg) at rest and during adenosine stress, rendering rest and stress ECV maps. Compared to males, females had higher perfusion, ECV, and MBV at stress, and perfusion and ECV at rest (p < 0.01 for all). Multivariate linear regression revealed that sex and MBV were associated with perfusion (sex beta -0.31, p = 0.03; MBV beta -0.37, p = 0.01, model R = 0.29, p < 0.01) while sex and hematocrit were associated with ECV (sex beta -0.33, p = 0.03; hematocrit beta -0.48, p < 0.01, model R = 0.54, p < 0.001). Myocardial perfusion, MBV, and ECV are higher in female healthy volunteers compared to males. Sex is an independent contributor to perfusion and ECV, beyond other physiological factors that differ between the sexes. These findings provide mechanistic insight into sex differences in myocardial physiology.
在健康个体中，关于心肌灌注、血容量（MBV）和细胞外容积（ECV）的性别差异的知识很少且相互矛盾。因此，本研究通过心血管磁共振（CMR）对此进行了定量研究。41 名健康志愿者（51%为女性）在 1.5T 下接受 CMR 检查。在腺苷应激期间和静脉注射对比剂（0.05mmol/kg，钆布醇）后静息状态下采集定量 MBV [%]和灌注 [ml/min/g]图。在腺苷应激前后和静息时（0.2mmol/kg）以及腺苷应激期间采集静息和应激时的 T1 原始图，生成静息和应激时的 ECV 图。与男性相比，女性在应激时的灌注、ECV 和 MBV 较高，在静息时的灌注和 ECV 也较高（所有 p 值均 < 0.01）。多元线性回归显示，性别和 MBV 与灌注相关（性别β值为-0.31，p=0.03；MBVβ值为-0.37，p=0.01，模型 R=0.29，p<0.01），而性别和红细胞压积与 ECV 相关（性别β值为-0.33，p=0.03；红细胞压积β值为-0.48，p<0.01，模型 R=0.54，p<0.001）。与男性相比，女性健康志愿者的心肌灌注、MBV 和 ECV 较高。性别是灌注和 ECV 的独立影响因素，超出了性别之间存在的其他生理因素。这些发现为心肌生理学中的性别差异提供了机制上的见解。
