Anastasia Susie Mihailidou

Anastasia Susie Mihailidou

Royal North Shore Hospital & University of Sydney, Australia

Title: Sex differences during myocardial infarction: Role of autophagy


Anastasia Susie Mihailidou is a cardiovascular clinical scientist, graduating with a Ph.D. in Pharmacology from University of Sydney in 1988. She is currently Clinical Senior Lecturer for Sydney Medical School, University of Sydney and Senior Hospital Scientist at Royal North Shore Hospital. Anastasia has both clinical and basic research interests as Director of the Ambulatory Blood Pressure Monitoring Service for a major Tertiary Referral Centre and Head of the Cardiovascular & Hormonal Research Laboratory. Her research focus is regulation of aldosterone/mineralocorticoid receptors in the heart and has made a signifi cant contribution to understanding the role of corticosteroid hormones (and antagonists). She was the fi rst to show aldosterone has both rapid and sustained effects on regulation of sodium transport in the heart, with increased levels of intracellular sodium. These fi ndings have generated great interest, leading to award of the Pfi zer Prize for best research at the International Society of Hypertension (2002). Her current research focus is to determine the role of aldosterone and mineralocorticoid receptors in diabetes.


Ischemic heart disease continues to be the leading cause of mortality, morbidity and burden of disease, with gender differences reported in presentation and clinical outcomes; the incidence in men is almost twice that in women, although more women than men die suddenly without any previous symptoms. Th ere is increased interest in defining the mechanisms for the sex related differences in cardiac damage following myocardial infarction, however, conflicting reports continue. Myocardial ischemia reduces blood fl ow and triggers programmed cell death (apoptosis), with progressive loss of cardiomyocytes resulting in tissue damage. Primary clinical strategy is to restore blood fl ow although this may further increase tissue damage, myocardial reperfusion injury (I/R). Autophagy, a cell survival pathway which is induced during I/R. We examined the role of androgens and estrogens during myocardial infarction (MI) in male and female animals, and how autophagy and apoptosis may contribute to the sex differences in cardiac damage. Mature age-matched male and female Sprague Dawley rats were used intact or surgically gonadectomized. Animals were anesthetised and hearts isolated and subjected to regional ischemia-reperfusion (I-R). In males, regional myocardial I-R in hearts from intact male rats produced significantly larger infarct size than those from female rats. Aggravated reperfusion injury correlated with increased apoptosis in the area at risk, consistent with the smaller infarct size in female hearts there was signifi cantly less apoptosis. We also found a gender dependent shift in the balance between autophagy and apoptosis, which has not been previously reported.

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