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Sex Differences, Genetic and Environmental Influences on Dilated Cardiomyopathy

1
Department of Cardiovascular Medicine, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA
2
Department of Cancer Biology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA
3
Genomic and Personalized Medicine, Atwal Clinic, 214 Brazilian Avenue, Suite 230, Palm Beach, FL 33480, USA
*
Authors to whom correspondence should be addressed.
Academic Editor: Martina Calore
J. Clin. Med. 2021, 10(11), 2289; https://doi.org/10.3390/jcm10112289
Received: 31 March 2021 / Revised: 11 May 2021 / Accepted: 18 May 2021 / Published: 25 May 2021
(This article belongs to the Special Issue Clinical and Research of Genetic Cardiomyopathies)
Dilated cardiomyopathy (DCM) is characterized by dilatation of the left ventricle and impaired systolic function and is the second most common cause of heart failure after coronary heart disease. The etiology of DCM is diverse including genetic pathogenic variants, infection, inflammation, autoimmune diseases, exposure to chemicals/toxins as well as endocrine and neuromuscular causes. DCM is inherited in 20–50% of cases where more than 30 genes have been implicated in the development of DCM with pathogenic variants in TTN (Titin) most frequently associated with disease. Even though male sex is a risk factor for heart failure, few studies have examined sex differences in the pathogenesis of DCM. We searched the literature for studies examining idiopathic or familial/genetic DCM that reported data by sex in order to determine the sex ratio of disease. We found 31 studies that reported data by sex for non-genetic DCM with an average overall sex ratio of 2.5:1 male to female and 7 studies for familial/genetic DCM with an overall average sex ratio of 1.7:1 male to female. No manuscripts that we found had more females than males in their studies. We describe basic and clinical research findings that may explain the increase in DCM in males over females based on sex differences in basic physiology and the immune and fibrotic response to damage caused by mutations, infections, chemotherapy agents and autoimmune responses. View Full-Text
Keywords: dilated cardiomyopathy; familial dilated cardiomyopathy; idiopathic dilated cardiomyopathy; sex differences; sex ratio; pathogenesis; environment; virus; genes dilated cardiomyopathy; familial dilated cardiomyopathy; idiopathic dilated cardiomyopathy; sex differences; sex ratio; pathogenesis; environment; virus; genes
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MDPI and ACS Style

Jain, A.; Norton, N.; Bruno, K.A.; Cooper, L.T., Jr.; Atwal, P.S.; Fairweather, D. Sex Differences, Genetic and Environmental Influences on Dilated Cardiomyopathy. J. Clin. Med. 2021, 10, 2289. https://doi.org/10.3390/jcm10112289

AMA Style

Jain A, Norton N, Bruno KA, Cooper LT Jr., Atwal PS, Fairweather D. Sex Differences, Genetic and Environmental Influences on Dilated Cardiomyopathy. Journal of Clinical Medicine. 2021; 10(11):2289. https://doi.org/10.3390/jcm10112289

Chicago/Turabian Style

Jain, Angita, Nadine Norton, Katelyn A. Bruno, Leslie T. Cooper Jr., Paldeep S. Atwal, and DeLisa Fairweather. 2021. "Sex Differences, Genetic and Environmental Influences on Dilated Cardiomyopathy" Journal of Clinical Medicine 10, no. 11: 2289. https://doi.org/10.3390/jcm10112289

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