Discovering why stiff heart failure affects more women than men

Heart failure with preserved ejection fraction (HFpEF) is a highly prevalent disease that accounts for over 50 per cent of all heart failure cases worldwide. Women make up a disproportionately high number – approximately two thirds – of cases.

The Cardiometabolic Disease Group at the Heart Research Institute (HRI) is conducting research to understand this anomaly with the goal of developing improved treatments for HFpEF. Ren Ping Liu, a PhD student with the Group, discussed their research findings at the 70th Annual Scientific Meeting of the Cardiac Society of Australia and New Zealand (CSANZ) at the Exhibition Convention Centre, Gold Coast in August 2022.

Patients present with a range of symptoms for HFpEF. They may experience difficult or laboured breathing (dyspnoea), fluid retention, lethargy and dizziness. Common risk factors are age (risks rise in female patients over 50), obesity, high blood pressure and diabetesamong others.

The symptoms present more severely in women than in men, and women also have additional comorbidities, such as iron deficiency, a higher risk of autoimmune diseases and a history of preeclampsiaduring pregnancy.

The team has devel­oped a first-of-its-kind ​’HFpEF pro­to­col’ in lab­o­ra­to­ry mod­els to mim­ic the dis­ease process.

In examining this protocol for gender-specific characteristics relating to blood pressure, exercise exhaustion and more, they found that it is likely that females have higher levels of circulating β-hydroxybutyrate (BHB), the most abundant type of ketone body in the circulatory system. These promising results open a pathway for the team to continue their research to understand if ketones might have a role to play in future therapies for HFpEF.

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