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European Heart Journal Advance Access published online on May 22, 2009
European Heart Journal, doi:10.1093/eurheartj/ehp188
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org

Gender differences in sympathetic neural activation following uncomplicated acute myocardial infarction

Andrew J. Hogarth*, Lee N. Graham, David A.S.G. Mary and John P. Greenwood

Department of Cardiology, Leeds Teaching Hospital NHS Trust, G floor, Jubilee wing, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UK

Received 2 December 2008; revised 26 February 2009; accepted 16 April 2009 * Corresponding author. Tel: +44 113 2432799, Fax: +44 113 3925787, Email: andy_hogarth2003{at}yahoo.co.uk

Aims: To determine whether the magnitude of post-acute myocardial infarction (AMI) sympathetic activation is greater in women (F-AMI) than men (M-AMI).

Methods and results: Both sympatho-humoral activation and female gender are associated with worse outcome in the early phase following AMI. However, women have lower sympathetic output than men. We therefore examined matched groups of F-AMI (18) and M-AMI (18) patients 2–4 days following uncomplicated AMI, then 3 monthly to 9 months; matched normal control (NC) groups comprised M-NC (18) and F-NC (18). Muscle sympathetic nerve activity (MSNA) was measured by microneurography. Muscle sympathetic nerve activity was lower in the F-NC than M-NC (at least P < 0.05) and greater in the two AMI groups than their corresponding NC groups (at least P < 0.001). Muscle sympathetic nerve activity was similar in the F-AMI and M-AMI groups indicating a post-AMI increase in women of about twice that in men (P < 0.0001). Both AMI groups returned to corresponding NC (lower in women) levels by 9 months.

Conclusion: Following uncomplicated AMI, women developed a relatively greater magnitude of sympathetic activation lasting until its resolution at 9 months. This is consistent with reports of their worse prognosis observed during this time period, with important potential clinical implications.

Key Words: Nervous system-sympathetic • Gender • Women • Myocardial infarction • Action potentials


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J. S. Floras and S. Mak
Muscle sympathetic nerve activity in women and men following acute myocardial infarction: a meaningful difference?
Eur. Heart J., July 2, 2009; 30(14): 1692 - 1694.
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