As with other cardiovascular diseases, there are sufficient data to suggest significant gender-related differences in the prevalence and presentation of congestive heart failure and myocardial diseases. From animal studies, it is apparent that there are sex-related differences in intrinsic ventricular function and in the cardiovascular response to various stimuli, which are at least partly modulated through direct effects of sex hormones on the heart. Although similar data are not available in humans, it seems likely that similar gender-related differences in cardiac function exist and may in part account for the observed differences in myocardial diseases in men and women. Additionally, genetic factors may contribute to these differences, as X-linked disorders may present differently in males and females. An awareness of the impact of sex-related factors is clearly important in the evaluation of any patient presenting with heart failure or cardiomyopathy and may alter both diagnostic and therapeutic considerations, as well as broaden our basic knowledge and understanding of the pathogenetic mechanisms involved in myocardial dysfunction.
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