Thromb Haemost 2019; 119(09): 1379-1381
DOI: 10.1055/s-0039-1695010
Invited Editorial Focus
Georg Thieme Verlag KG Stuttgart · New York

Gender Specificity and Interpretation of Functional Cardiac Imaging: Let's Talk about Sex

Baris Gencer
1  Cardiology Division, Geneva University Hospitals, Geneva, Switzerland
2  TIMI Study Group, Brigham and Women's Hospitals, Harvard Medical School, Boston, Massachusetts, United States
François Mach
1  Cardiology Division, Geneva University Hospitals, Geneva, Switzerland
› Author Affiliations
Further Information

Publication History

17 July 2019

17 July 2019

Publication Date:
01 September 2019 (online)


In their present study, Fiechter et al report from nuclear medicine that for women, a strong association exists between inflammation, as measured by vertebral bone marrow metabolism, and impaired myocardial function and perfusion, as assessed by single photon emission computed tomography-myocardial perfusion imaging (SPECT-MPI).[1] Among a total of 294 patients (28.6% women, mean age 67 years old) who underwent 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography and 99Tc-tetrofosmin SPECT-MPI, a significant increase in 18F-FDG bone marrow uptake was observed in women with impaired myocardial perfusion as compared with normal myocardial perfusion (standardized uptake 2.2 ± 1.2 vs. 1.7 ± 1.2, p = 0.013), while no differences were found in men (1.6 ± 0.8 vs. 1.6 ± 0.4, p = 0.372). In addition, a significant inverse correlation between left ventricular ejection fraction and bone marrow metabolism was seen in women (r = –0.229, p = 0.037), but not in men (r = –0.075, p = 0.289). The present findings are relevant, interesting, and novel as no previous study has applied two different nuclear medicine imaging modalities simultaneously to investigate the degree of inflammation and the amount of myocardial ischemia perfusion in the same patient. In particular, a major difference between genders was found, suggesting the importance of the gender specificity when interpreting cardiac functional test.