ArticleCardiovascular diabetology2025
Sex differences in myocardial flow reserve among individuals with type 2 diabetes: insights from the DiaHeart study.
Article in Cardiovascular diabetology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- The prognostic value of quantitative myocardial blood flow and flow reserve by dynamic CZT-SPECT for major adverse cardiovascular events.European journal of nuclear medicine and molecular imaging · 2026Article
- Establishing normal myocardial blood flow and myocardial flow reserve values: a rubidium-82 positron emission tomography study.European journal of nuclear medicine and molecular imaging · 2026Article
- Associations between cardiac adipose tissue volume, measures of coronary calcification, myocardial microvascular function and systemic inflammation in individuals with type 2 diabetes free of overt cardiovascular disease.Cardiovascular diabetology · 2026Article
- Sex-Specific Associations With Abnormal Myocardial Flow Reserve in Non-Obstructive Coronary Artery Disease: Insights From a Real-World Cadmium-Zinc-Telluride SPECT Study.Clinical cardiology · 2026Article
- Left ventricular ejection fraction reserve and its association with myocardial perfusion, coronary calcification, and strain in type 2 diabetes without overt cardiovascular disease.Cardiovascular diabetology · 2025Article
- Coronary Microvascular Dysfunction in Ischaemic Heart Disease: Lessons From Large Animal Models.Basic & clinical pharmacology & toxicology · 2025Review
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Authors and funding
17 authors.
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Abstract
backgroundType 2 diabetes is a stronger risk factor for cardiovascular disease (CVD) in women compared with men possibly due to higher susceptibility to develop myocardial microvascular dysfunction. We investigated sex-dependent effects of risk factors on myocardial blood flow (MBF) and myocardial flow reserve (MFR) in individuals with type 2 diabetes without overt CVD.
methodsCross-sectional analysis of a prospective study including 901 individuals recruited between 2020 and 2023. All participants underwent a cardiac 82-Rubidium positron emission tomography/computed tomography scan to quantify MBF at rest and during pharmacologically induced stress, allowing for calculation of MFR. Linear regression, with/without interaction terms for sex, was used to test whether sex modified the association between MFR/MBF and risk factors.
resultsMean (SD) age was 65 (8.9) years, diabetes duration was 14 (8.4) years, and 266 (29.5%) were women. Women had higher MBF at rest and stress but had lower MFR (mean (SD) 2.44 (0.67) vs. 2.59 (0.77), p = 0.003) than men. A similar proportion of men and women (21.1% vs. 23.7%) had an MFR < 2. The decline in predicted MFR with age differed between sexes. At age 55, women had a mean MFR that was 0.29 lower than men (95% CI: - 0.44 to - 0.14), but by age 75, this difference had nearly disappeared (- 0.04, 95% CI: - 0.19 to 0.11). However, after adjustment for other risk factors, the interaction between sex and age was not statistically significant (p = 0.057). No other risk factors exhibited significant sex-dependent interactions.
conclusionsIn individuals with type 2 diabetes without overt CVD, women exhibited lower MFR than men, primarily due to higher MBF at rest, suggesting sex-related differences. While MFR declined in both sexes, the sex difference was more pronounced in younger individuals and diminished over time. These findings underscore the need for further research into sex-specific thresholds for MFR in cardiovascular risk stratification.
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