title: Gender differences in myocardial blood flow dynamics: lipid profile and hemodynamic effects.
abstract: OBJECTIVE
  The purpose of the study was to compare myocardial blood flow (MBF) in hyperlipidemic postmenopausal women and age-matched hyperlipidemic men, and to analyze the relationship between cholesterol subfractions and myocardial blood flow in men and women.
  
  
  BACKGROUND
  Women are protected from coronary artery disease (CAD) events until well after menopause, in part due to gender-specific differences in lipid profiles.
  
  
  METHODS
  To examine the effect of these influences on coronary microcirculation, MBF was quantitated with N-13 ammonia/PET (positron emission tomography) at rest and during adenosine hyperemia in 15 women and 15 men, all nondiabetic, who were matched for age and total cholesterol levels (53+/-4 vs. 50+/-8 years, p = NS, 6.44+/-1.1 vs. 6.31+/-0.85 mmol/liter, or 249+/-41 vs. 244+/-33 mg/dl, p = NS).
  
  
  RESULTS
  Women had significantly higher high density lipoprotein (HDL) and lower triglyceride (Tg) levels than did men, and they showed significantly higher resting MBF and stress MBF levels. Significant correlations were found between resting and hyperemic MBF and HDL and Tg levels (r = 0.44, p < 0.02 for stress MBF vs. HDL; r = 0.48, p < 0.007 for stress MBF vs. Tg). Gender was the strongest predictor of hyperemic MBF in multivariate analysis. Women responded to adenosine hyperemia with a significantly higher heart rate than did men, and hemodynamic factors correlated significantly with blood flow both at rest and during stress.
  
  
  CONCLUSIONS
  These data suggest that the favorable lipid profile seen in women may be associated with preserved maximal blood flow in the myocardium.
authors.affiliation: Nuklearmedizinische Klinik und Poliklinik, Munich, Germany.
authors.forename: C S
authors.initials: CS
authors.lastname: Duvernoy
authors.forename: C
authors.initials: C
authors.lastname: Meyer
authors.forename: V
authors.initials: V
authors.lastname: Seifert-Klauss
authors.forename: F
authors.initials: F
authors.lastname: Dayanikli
authors.forename: I
authors.initials: I
authors.lastname: Matsunari
authors.forename: J
authors.initials: J
authors.lastname: Rattenhuber
authors.forename: C
authors.initials: C
authors.lastname: Höss
authors.forename: H
authors.initials: H
authors.lastname: Graeff
authors.forename: M
authors.initials: M
authors.lastname: Schwaiger
mesh_terms: D000241:Adenosine; D002784:Cholesterol / Q000097:blood; D003326:Coronary Circulation; D003327:Coronary Disease / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate; D006801:Humans; D006940:Hyperemia / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology; D006949:Hyperlipidemias / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology; D008055:Lipids / Q000097:blood*; D008075:Lipoproteins, HDL / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D017698:Postmenopause / Q000097:blood; D011379:Prognosis; D012039:Regional Blood Flow; D012146:Rest / Q000502:physiology; D012307:Risk Factors; D012727:Sex Characteristics; D014055:Tomography, Emission-Computed; D014280:Triglycerides / Q000097:blood; D014665:Vasodilator Agents