Pressure overload (PO) first causes cardiac hypertrophy and then heart failure (HF), which are associated with sex differences
in cardiac morphology and function. We aimed to identify genes that may cause HF-related sex differences. We used a transverse
aortic constriction (TAC) mouse model leading to hypertrophy without sex differences in cardiac function after 2 weeks, but
with sex differences in hypertrophy 6 and 9 weeks after TAC. Cardiac gene expression was analyzed 2 weeks after surgery. Deregulated
genes were classified into functional gene ontology (GO) categories and used for pathway analysis. Classical marker genes
of hypertrophy were similarly upregulated in both sexes (α-actin, ANP, BNP, CTGF). Thirty-five genes controlling mitochondrial
function (PGC-1, cytochrome oxidase, carnitine palmitoyl transferase, acyl-CoA dehydrogenase, pyruvate dehydrogenase kinase)
had lower expression in males compared to females after TAC. Genes encoding ribosomal proteins and genes associated with extracellular
matrix remodeling exhibited relative higher expression in males (collagen 3, matrix metalloproteinase 2, TIMP2, and TGFβ2,
all about twofold) after TAC. We confirmed 87% of the gene expression by real-time polymerase chain reaction. By GO classification,
female-specific genes were related to mitochondria and metabolism and males to matrix and biosynthesis. Promoter studies confirmed
the upregulation of PGC-1 by E2. Less downregulation of metabolic genes in female hearts and increased protein synthesis capacity
and deregulation of matrix remodeling in male hearts characterize the sex-specific early response to PO. These differences
could contribute to subsequent sex differences in cardiac function and HF.
Keywords Pressure overload - Hypertrophy - Gene expression - Sex - Heart
Henning Witt and Carola Schubert contributed equally to this work.