Research >> SP13 - Gender differences

Gender Differences in Heart Failure after Coronary Artery Bypass Graft Surgery - Project description

Background

Subproject 13 was initiated and launched based on the results of a large retrospective study at the German Heart Institute Berlin, which revealed significant differences in progress after aortocoronary bypass surgery to the disadvantage of women, whereby no significant gender differences in the influence of numerous clinical parameters were found. This prospective study examines the influence of heart failure, hormone status and psychosocial factors on the result after ACVB surgery.

Clinical symptoms of systolic heart failure were more frequent in women in the retrospective analysis. In associated studies of the German Heart Institute Berlin, biopsies taken during surgery revealed indications of gender-specific differences in mechanisms for adaptation to ischemia, which could be the cause of diastolic dysfunction.

Objective

Thus, the primary goals of the subproject, in cooperation with other subprojects, are the investigations of

  1. gender-specific factors which have a substantial influence on cardiovascular mortality and morbidity within the first year after ACVB surgery, whereby the influence of systolic and diastolic functional limitations in women play a main role,
  2. and the influence of hormonal and psychosocial factors on progress after ACVB surgery.

Fundamental information for the improvement of management of the disease should be gained from this data. Knowledge and targeted monitoring of the risk factors for women as well as men saves resources and facilitates better intervention planning. This applies to the planning of surgical interventions as well as interventions in the hormone status and psychosocial care. Moreover, the following molecular and genetic analyses facilitate the discovery and targeted use of new or existing drug strategies.

Implementation

This is a prospective clinical study of patients with coronary heart disease who underwent ACVB surgery. By the end of May 2006, pre-, intra- and postoperative variables were recorded for 1,050 patients. The data of the 2-month observation period for 900 patients and for the 1-year observation period for 200 patients are available, in which total morbidity and mortality were documented in the course of illness.

Initial results show a tendency toward more frequent clinical signs of heart failure (stress dyspnea) preoperatively with a better left ventricular ejection fraction. Impairment of psychosocial well-being is worse in women both preoperatively as well as in the early postoperative stage (2-month follow-up) than in men.

Added value via networking

The project looks at a large and important patient group with gender-specific manifestations of heart failure and the significance of these with regard to the prognosis, underlying mechanisms, interactions with psychosocial and hormonal components and treatment options. This puts the project at the heart of the network‘s focus on interdisciplinarity.

Networking facilitates the optimization of the use of specific data on gender-specific mechanisms and the significance of heart failure before and after ACVB surgery, which improves the treatment management for both women and men.