After decades of leading-edge research into sex-based differences in women’s heart disease and physiology, clinician-investigators at the Barbra Streisand Women’s Heart Center of the Smidt Heart Institute have fine-tuned their approach to diagnostics and care
The center brings unique insight into overlooked or misunderstood symptoms by applying advanced cardiac imaging and biomarker analysis that illuminate subtleties in presentation and disease progression among female patients. This expertise improves screening and diagnostic accuracy, enabling sex-appropriate treatment plans.
This contextual expertise arises from a number of trailblazing studies, such as the U.S. Department of Defense-funded Women’s IschemiA TRial to Reduce Events In Non-ObstRuctive CAD (WARRIOR), which aims to identify whether point-of-care prescriptions are effective for reducing heart disease in women. As these clinical investigations bear fruit for clinical practice, our physicians actively apply the latest evidence to generate care guidelines that can help women everywhere.
A Smidt Heart Institute study suggests middle-aged and older women are being diagnosed with Takotsubo syndrome more frequently—up to 10 times more often—than younger women or men of any age.
SMALL VESSEL DYSFUNCTION
This silent disease, which can result in progression to heart failure with preserved ejection fraction, has long puzzled cardiologists and evaded traditional imaging. A new NIH grant allows our investigative cardiologists to use novel MRI techniques to test the hypothesis that oxygen deprivation to the heart caused by small vessel dysfunction eventually forces heart muscle cells to revert to fetal metabolism. This metabolic switch from burning fat cells to using glucose may result in difficulty clearing triglycerides, resulting in small vessel dysfunction and heart failure.
THE “FRAMINGHAM OF PREGNANCY” STUDY
Cedars-Sinai cardiologists provide investigative leadership and biorepository services for the prospective Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be Heart Health Study (nuMoM2b-HHS). Funded by the National Heart, Lung, and Blood Institute and the National Institute of Child Health and Human Development, the study will follow a portion of its 10,038 original participants for decades. It has already revealed an association between a history of migraines and adverse pregnancy outcomes.
RELEVANT RECENT PUBLICATIONS
Ischemia and No Obstructive Coronary Artery Disease (INOCA): Developing Evidence-Based Therapies and Research Agenda for the Next Decade, Circulation; PMID: 28289007
Mortality Risk in Takotsubo Syndrome Versus Myocarditis, Journal of the American Heart Association; PMID: 35766264
Autologous CD34+ Stem Cell Therapy Increases Coronary Flow Reserve and Reduces Angina in Patients With Coronary Microvascular Dysfunction, Circulation: Cardiovascular Interventions; 15:e010802
A focus on cardio-obstetrics
A combination of improved survival into adulthood among women with adult congenital heart disease (ACHD) and older women becoming pregnant has culminated in an increased need for cardiac expertise prior to, during and immediately after pregnancy.
Our cardio-obstetrics program has a creative infrastructure to maximize high-value care for severe hypertension, peripartum cardiomyopathy or other high-risk conditions throughout pregnancy. Trained nurses manage chronic conditions and preventive care efforts, with specialist oversight in case of emergency or acute care needs. Close collaboration with maternal-fetal medicine experts and ACHD cardiologists (paired, as needed, with comprehensive follow-up in the postpartum heart clinic and the Barbra Streisand Women’s Heart Center) ensures pregnancy-related cardiac conditions no longer go unrecognized and undertreated.