Heart failure & cardiomyopathiesResearch article
Sex Differences in Skeletal Muscle Inflammation and Dysfunction in Patients With Heart Failure and Reduced Ejection Fraction
- Study of patients with heart failure with reduced ejection fraction (HFrEF) and age- and sex-matched healthy controls
- vastus lateralis muscle biopsies analyzed by flow cytometry
- linear regression with sex-by-HFrEF interaction
Authors' conclusion
Skeletal muscle immune cell alterations, particularly macrophage and lymphocyte imbalances, are associated with muscle dysfunction in HFrEF, exhibiting distinct sex-specific patterns. These findings demonstrate sex-specific skeletal muscle inflammation and dysfunction in HFrEF.
Study context
- Population
- Patients with heart failure with reduced ejection fraction (HFrEF) and age- and sex-matched healthy controls (mean age, 71±7 years; 32% women)86 patients with HFrEF and 41 age- and sex-matched healthy controls · patients with HFrEF 86 · age- and sex-matched healthy controls 41
- Participants
- 86 vs 41
- Comparison
- HFrEF vs healthy controls
- HFrEFn = 86
- healthy controlsn = 41
Main finding
As reported in the abstract
Skeletal muscle immune cell composition, sex-by-HFrEF interaction
macrophage fraction, interaction
P =0.006
lymphocyte content, interaction
P =0.045
lymphocyte fraction, interaction
P =0.039
Further findings
| Outcome | Values | GMR (CI) | P value |
|---|---|---|---|
| Lymphocyte fraction in women with HFrEF · increased lymphocyte fraction in women in HFrEF | 1.27 (1.06–1.53) | P = 0.014 | |
| Macrophage content in men with HFrEF · increased macrophage content in men in HFrEF | 1.75 (1.16–2.64) | P = 0.009 | |
| Association of macrophage content with muscle mass and strength | women mass R 0.42, P =0.014 · strength R 0.42, P =0.013 · men mass R −0.25, P =0.017 · strength R −0.21, P =0.046 | ||
| Muscle stem cells and fibro-adipogenic progenitor cells — HFrEF · muscle stem cells; reduced in HFrEF | 1.92 (0.99–3.74) | P = 0.054 | |
| Muscle stem cells and fibro-adipogenic progenitor cells — HFrEF · fibro-adipogenic progenitor cells; reduced in HFrEF | 1.72 (1.03–2.85) | P = 0.038 |
- Association of macrophage content with muscle mass and strength: greater muscle mass and strength in women, reduced mass and strength in men
Original publication
Sex Differences in Skeletal Muscle Inflammation and Dysfunction in Patients With Heart Failure and Reduced Ejection Fraction. Circ Heart Fail. Published 27 August 2026. doi:10.1161/circheartfailure.125.014062
Summarised from the published abstract; every number is checked against it