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Review
. 2020 Aug 8;22(10):102.
doi: 10.1007/s11886-020-01377-z.

Sex-Related Differences in Dilated Cardiomyopathy with a Focus on Cardiac Dysfunction in Oncology

Domenico D'Amario  1 , Massimiliano Camilli  2 , Stefano Migliaro  2 , Francesco Canonico  2 , Mattia Galli  2 , Alessandra Arcudi  2 , Rocco Antonio Montone  1 , Josip Andjelo Borovac  3 , Filippo Crea  1   2 , Gianluigi Savarese  4
Affiliations
Review

Sex-Related Differences in Dilated Cardiomyopathy with a Focus on Cardiac Dysfunction in Oncology

Domenico D'Amario et al. Curr Cardiol Rep. .

Abstract

Purpose of review: The aim of this report is to describe the main aspects of sex-related differences in non-ischemic dilated cardiomyopathies (DCM), focusing on chemotherapy-induced heart failure (HF) and investigating the possible therapeutic implications and clinical management applications in the era of personalized medicine.

Recent findings: In cardio-oncology, molecular and multimodality imaging studies confirm that sex differences do exist, affecting the therapeutic cardioprotective strategies and, therefore, the long-term outcomes. Interestingly, compelling evidences suggest that sex-specific characteristics in drug toxicity might predict differences in the therapeutic response, most likely due to the tangled interplay between cancer and HF, which probably share common underlying mechanisms. Cardiovascular diseases show many sex-related differences in prevalence, etiology, phenotype expression, and outcomes. Complex molecular mechanisms underlie this diverse pathological manifestations, from sex-determined differential gene expression to sex hormone interaction with their receptors in the heart. Non-ischemic DCM is an umbrella definition that incorporates several etiologies, including chemotherapy-induced cardiomyopathies. The role of sex as a risk factor for cardiotoxicity is poorly explored. However, understanding the various features of disease manifestation and outcomes is of paramount importance for a prompt and tailored evaluation.

Keywords: Cardio-oncology; Dilated cardiomyopathy; Heart failure; Sex difference.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Central illustration synthesizing the main aspects of the paper. Patient-related, disease-related, and therapy-related differences induced by sex coexist, strongly impacting clinical manifestations, prognosis, and management. The integration of these aspects in clinical practice may favor the development of patient-tailored management strategies in the era of personalized medicine
See this image and copyright information in PMC

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