Gender differences and aging: Effects on the human heart

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Objectives.

This study investigated the changes in myocyte size and number in the left and right ventricles that occur with aging in the female and male heart.

Background.

Differences in life span between women and men may be related to a better preservation of myocardial structure in the female heart with aging. On this basis, the hypothesis was advanced that the aging process has a different impact on the integrity of the myocardium in the two genders.

Methods.

Morphometric methodologies were applied to analyze the changes in number and size of ventricular myocytes in the hearts of 53 women and 53 men. The changes in mononucleated and binucleated myocytes with age were determined in enzymatically dissociated cells. The age interval examined varied from 17 to 95 years.

Results.

Aging was associated with a preservation of ventricular myocardial mass, aggregate number of mononucleated and binucleated myocytes, average cell diameter and volume in the female heart. In contrast, nearly 1 g/year of myocardium was lost in the male heart, and this phenomenon accounted for the loss of ∼64 million cells. This detrimental effect involved the left and right sides of the heart. In the remaining cells, myocyte cell volume increased at a rate of 158 μm3/year in the left and 167 μm3/year in the right ventricle.

Conclusions.

Aging does not lead to myocyte cell loss and myocyte cellular reactive hypertrophy in women, indicating that gender differences may play a significant role in the detrimental effects of the aging process on the heart.

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This work was supported by Grants HL-38132, HL-39902 and HL-40561 from the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland.