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German Center for Cardiovascular Research (DZHK)
Berlin is with Charité – Universitätsmedizin Berlin, Max-Delbrück-Centrum for Molecular Medicine (MDC) and the German Heart Institute (DHZB) one of seven locations of the German Center for Cardiovascular Research (DZHK), the partners bundled their research in the fields of the cardiovascular and metabolic systems in a common project called "Cardio Berlin". Goal of the DZHK is a direct translation of basic research results to praxis by strong cooperation with the clinics. Coordinator of Cardio Berlin is Prof. Vera Regitz-Zagrosek. The project "Cardio Berlin" focuses on prevention and additionally on sex differences in cardiovascular diseases. Clinicians and researchers work together interdisciplinarily and deal with the latest methods in molecular genetics and imaging techniques as well as approaches of systems biology. The group of Prof. Vera Regitz-Zagrosek focuses on the sex-specific effects of estrogen on contractility and calcium metabolism.
Research Group Myocardial Hypertrophy (DFG, FOR 1054)
The main aim of the research group "Myocardial Hypertrophy" (FOR 1054) is the analysis of gender differences in the adaptation of the heart to mechanical stress. In this research group, we perform a series of mechanical analysis using cell cultures and animal models. This includes models of physiological and pathological myocardial stress, e.g. strength training and hypertension. The role of estrogen and androgen receptors is selectively analyzed. Moreover, the effect of sex hormones on the lipid turnover is investigated. Several collaborations with clinical projects exist; in this area we mainly focus on gender differences in myocardial reaction to overload due to aortic valve disease.
Graduate Training Group 754
Graduate training group GK 754 "Gender-specific mechanisms of myocardial hypertrophy" (DFG) originates from the collaboration of 12 principal investigators within Charité, 8 at the Center for Cardiovascular Research (CCR), and the German Heart Institute in Berlin. It comprises four interconnected modules: 1) Animal models of hypertrophy, 2) functional genomics and proteomics, 3) gender-specific molecular mechanisms and 4) gender aspects in the clinics of cardiovascular diseases. In this project, the research group of Prof. Regitz-Zagrosek is analyzing the sex-specific regulation of the energy metabolism and its influence on heart function. Furthermore, matrix synthesis and its control by estrogen is analyzed. Another goal is the identification of transcriptional factors and their potential binding sites within the promoter region of matrixmetalloproteinases (MMP-2), as well as the characterization of other matrix-related genes. This was founded in 2001-2011 and is sustained in the activities of the young CCR initiative. A novel international activity is planed as follow up.
EuGeneHeart European Integrated Project
The team of Prof. Regitz-Zagrosek participated in the EU-funded EUGeneHeart project. The project aimed at the elucidation of the mechanisms leading from myocardial hypertrophy to heart failure. Task number 4 "gender" was coordinated by Prof. Regitz-Zagrosek and included collaboration with research groups at the INSERM (Institut National de la Santé et de la Recherche Médicale) and the Karolinska Institute. Aim was the investigation of gender differences in myocardial hypertrophy induced by stress, training, infarction and pressure. Experiments were performed using cell cultures and animal models and focused on the role of sex hormones.
Gender differences in human aortic stenosis
In 2006 a single project has been designed to link basic and clinical research in analysing gender differences in human aortic stenosis. The project was funded by the DFG, German Research Foundation (DFG-Re 662/6-1, Dwo 70/1-1) and is submitted to prolongation. Gender-specific differences after aortic valve transplantation are investigated in patients and in experimental animal models.
In the area of clinical research we conduct studies with primarily cardiologic focus and maintain intense collaboration with the German Heart Institute in Berlin. We also collaborate with the German Competence Network "Heart Failure" and were able to introduce our sex/gender-specific point of view. We also work at the definition of the young discipline of gender medicine and its current state-of-the-art through the Pilot project "Gender Medicine" funded by the BMBF. Within this project we test scientific publications for gender relevance and systematically classify the results.
ESC Guidelines on the management of cardiovascular diseases during pregnancy
In 2011 the first guidelines with classified recommendations on the management of cardiovascular diseases during pregnancy coordinated by Prof. Vera Regitz-Zagrosek were created and published by the European Society of Cardiology (ESC). Pregnant women with heart diseases should be advised by an interdisciplinary team of gynaecologists, cardiologists and perhaps by cardiac surgeons early during pregnancy to minimize maternal and fetal mortality. Because a single doctor will be faced with such patients rarely, these guidelines are very important.
Training and Teaching EUGIM
Aim of the project is the education of internationally approved experts with comprehensive knowledge in the area of sex and gender specific medicine and the development of a European network of university and non-university institutions. Seven internationally renowned European university professors from Germany, Italy, Austria, Hungary, the Netherlands and Sweden with professional expertise in sex and gender medicine develop and coordinate a curriculum for a flexible master module "Gender Medicine (GM)" within the European ERASMUS project. According to the variety of diseases with relevant sex/gender differences this module is divided in "basic subjects" and "additional subjects". The module comprises 5 ECTS. All parts of medicine are focussed concerning prevention up to therapy depending on the current state of research in "gender medicine" in Europe. Furthermore sociocultural aspects are focused. The module can be flexibly integrated into bachelor or master programmes or continuous medical education and will lead to an internationally recognized certificate. Network members will sensitize universities, medical professional organizations, the pharmaceutical industry, health care politics, funding organizations and insurance companies for gender aspects. Dissemination and awareness of gender aspects will improve treatment of both women and men and will reduce mortality and undesirable side effects of drug treatment. Furthermore the knowledge will be given to the general public as well. This will promote innovation in medical education and contribute to harmonization of biomedical study structures in Europe.