{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T19:34:22Z","timestamp":1792697662569,"version":"4.5.0"},"reference-count":92,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>Despite over a century of clinical electrocardiographic studies showing that women exhibit a faster resting heart rate (HR), the mechanisms underlying sex differences in HR remain unresolved. Moreover, inappropriate sinus tachycardia primarily affects women, whereas men are at a higher risk for conduction block and atrial fibrillation. We hypothesized that the sexual dimorphism of genes responsible for sinoatrial node (SAN) pacemaking and signaling pathways may contribute to the sex differences in HR and susceptibility to arrhythmias.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>Human SAN central pacemaker and right atrial tissue were isolated from nondiseased ex vivo donor hearts. Gene expressions were quantified and validated using the transcriptomic panel and quantitative polymerase chain reaction. Gene set enrichment analysis, Ingenuity Pathway Analysis, and human-specific SAN models were utilized to define regulatory mechanisms and functional impacts of sex-biased gene transcription.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              We identified differentially expressed region- and sex-specific genes, with gene sets enriched in HR regulation (eg,\n              <jats:italic toggle=\"yes\">TBX3<\/jats:italic>\n              ,\n              <jats:italic toggle=\"yes\">HCN1<\/jats:italic>\n              ) and metabolism (eg,\n              <jats:italic toggle=\"yes\">ADIPOQ<\/jats:italic>\n              ,\n              <jats:italic toggle=\"yes\">LEP<\/jats:italic>\n              ) pathways in female SAN. In contrast, differential genes and gene sets involved in collagen biosynthetic processes, fibrogenesis (eg,\n              <jats:italic toggle=\"yes\">EGR1<\/jats:italic>\n              ), and immune response (eg,\n              <jats:italic toggle=\"yes\">IL6<\/jats:italic>\n              ,\n              <jats:italic toggle=\"yes\">CXCL8<\/jats:italic>\n              ) pathways were enriched in males SAN and right atrial. Ingenuity Pathway Analysis predicted significant roles for\n              <jats:italic toggle=\"yes\">TBX3<\/jats:italic>\n              and estradiol in the sex-specific expression of genes involved in SAN function. Computational simulations showed that the sex-specific SAN differences in I\n              <jats:sub>f<\/jats:sub>\n              (pacemaker current;\n              <jats:italic toggle=\"yes\">HCN1<\/jats:italic>\n              ) and I\n              <jats:sub>Ca,L<\/jats:sub>\n              (L-type calcium current;\n              <jats:italic toggle=\"yes\">CACNA1D<\/jats:italic>\n              ) can explain the faster HR in female SAN, with female SAN having a lower threshold for inappropriate sinus tachycardia, whereas male SAN are more vulnerable to sinus arrest.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>\n              The human SAN exhibits region-specific sexual dimorphism in pacemaking gene sets. Higher expression of\n              <jats:italic toggle=\"yes\">TBX3<\/jats:italic>\n              and\n              <jats:italic toggle=\"yes\">HCN1<\/jats:italic>\n              in female SAN may underlie faster HR and increased susceptibility to inappropriate sinus tachycardia in women, whereas enriched gene sets related to inflammation and collagen biosynthesis in men may predispose them to conduction impairments and atrial fibrillation risk.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circep.124.013534","type":"journal-article","created":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T09:00:16Z","timestamp":1745398816000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Heart Rate Mystery Unveiled: Sex Differences in Human Sinoatrial Node Genes and Female Tachycardia"],"prefix":"10.1161","volume":"18","author":[{"given":"Ning","family":"Li","sequence":"first","affiliation":[{"name":"Department of Physiology and Cell Biology (N.L., P.J.M., V.V.F.), The Ohio State University College of Medicine Wexner Medical Center, Columbus."},{"name":"Bob and Corrine Frick Center for Heart Failure and Arrhythmia, Dorothy M. 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