title: Sex- and age-related differences of myocardial perfusion at rest assessed with multidetector computed tomography.
abstract: BACKGROUND
  The clinical presentation of ischemic heart disease in women differs from men, which could reflect sex-related differences of normal physiology. Cardiac CT angiography provides a noninvasive method to assess both regional and transmural myocardial perfusion in addition to coronary atherosclerosis.
  
  
  OBJECTIVE
  The aim of this study was to evaluate potential sex-related differences of (1) left ventricular (LV) myocardial perfusion measured as LV myocardial attenuation density/LV blood pool attenuation density (MyoAD-ratio) at rest and (2) transmural perfusion ratio (TPR) as a measure of endocardial perfusion relative to epicardial perfusion.
  
  
  METHODS
  Myocardial perfusion at rest and coronary artery atherosclerosis were evaluated with multidetector CT in 206 asymptomatic women and 203 age-matched men from the Copenhagen General Population Study.
  
  
  RESULTS
  LV myocardial perfusion at rest (LV MyoAD-ratio) was higher in women than in men (9% difference; P = 0.039). In a multivariable analysis, including age, sex, cardiovascular risk factors, Agatston score, and presence of coronary stenosis, global LV MyoAD-ratio remained significantly higher in women than in men (P = 0.045). No effect of cardiovascular risk factors on myocardial perfusion at rest was noted. Myocardial perfusion at rest was correlated to age in men (r = 0.15, P = 0.031) but not in women (r = -0.01, P = 0.83). TPR was slightly lower in women than in men (1.12 vs 1.14; P = 0.0019).
  
  
  CONCLUSIONS
  LV myocardial perfusion at rest is higher in women than men independent of coronary atherosclerosis in asymptomatic subjects with risk factors.
authors.affiliation: Department of Cardiology, The Heart Center, Rigshospitalet, University of Copenhagen, 2141, Blegdamsvej 9, 2100-Cph, Denmark. hsz199@alumni.ku.dk
authors.forename: Christina
authors.initials: C
authors.lastname: Byrne
authors.forename: J Tobias
authors.initials: JT
authors.lastname: Kühl
authors.forename: Mette
authors.initials: M
authors.lastname: Zacho
authors.forename: Børge G
authors.initials: BG
authors.lastname: Nordestgaard
authors.forename: Andreas
authors.initials: A
authors.lastname: Fuchs
authors.forename: Daria
authors.initials: D
authors.lastname: Frestad
authors.forename: Lars
authors.initials: L
authors.lastname: Køber
authors.forename: Klaus Fuglsang
authors.initials: KF
authors.lastname: Kofoed
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography / Q000706:statistics & numerical data*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000706:statistics & numerical data*; D015995:Prevalence; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D017678:Sex Distribution; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*