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No matter how you twist it or turn it, the male and female heart are just not the same. But in the world of science, sex differences in cardiac diseases remain structurally undervalued.

“I think the biggest problem in sex research is that all our standards are men,” says Elise Kessler. She works as a post-doc in the Experimental Cardiology and Regenerative Medicine Center at the UMC Utrecht. Her research aims to shine a light on the differences in development of cardiovascular diseases between men and women.

For some heart diseases, women do not show exactly the same symptoms as men and cardiac diseases are often not diagnosed as such in women.  Also, women can have a different progression of disease and can react differently to treatment dosage. Yet, for a long time it was not allowed for women to participate in clinical trials. So nowadays almost all clinical guidelines are based on data from men.

I think the biggest problem in sex research is that all our standards are men.

When Elise found out about this halfway through her PhD, she was shocked. “You realize that you will not ever have the proper medical attention, just because you are a woman.” To change this, Elise is going back to the cellular level.

Heart failure is often associated with a lot of comorbidities and risk factors, such as diabetes, obesity or age. These factors make it hard to investigate the influence of sex differences in patients. But cell cultures and animal models also rarely reflect sex differences. “Apparently, as a scientific community, we don’t really know why sex differences develop.” Elise realized that progress could be found in a novel in vitro system.

“We use induced pluripotent stem cells of healthy women or men to grow several different types of heart cells out of them. We first want to know what are the intrinsic and basic differences between the male and female cell-lines. Later, we will start triggering the cells with factors related to cardiovascular disease to see what happens in the cells.”

Changing diagnosis and treatment of course would be awesome, but just being aware what these differences are would be very important, for researchers and of course eventually for patients.

With her research she aims to stimulate awareness of the importance of sex difference in cardiac diseases. “Changing diagnosis and treatment of course would be awesome, but just being aware what these differences are would be very important, for researchers and of course eventually for patients.”