“The more muscle mass, the more capacity a woman’s heart has to pump blood,” they indicate Lean mass, on the other hand, does not significantly improve heart function in men In studies of the cardiovascular system, no one had ever looked at the periphery, at the muscles, and less to those of women, say Candela Díaz-Cañestro and David Montero Barril are part of one of the 50 best medical schools in the world: the University of Hong Kong and have just published a study that may be of great importance for women’s cardiovascular health. An observational analysis that relates the level of muscle mass with the state of the heart and that would answer questions that science has not yet been able to explain, they say. Candela Díaz-Cañestro (Santa Pola, 1989) is the main author of the study. David Montero Barril (Alicante, 1981), co-author. Two Spaniards who tell NIUS from Hong Kong how the musculature can influence, and a lot, the female heart. An interview, in the video that heads this information you can see an extract of it, in which they also detail how they managed to take the samples with an innovative machine, and tell their story: that of two Spaniards, both from Alicante, the two graduates in Sports Sciences, traveling a good part of the world to dedicate themselves to what they are passionate about: medical and physiological research. Question: To be healthy, as a woman, what is better: to be thin or to be strong and have good muscle mass? Candela: Being thin is good, we know that obesity is a risk factor for cardiovascular health, but we have discovered that lean mass or muscle mass can be decisive in women, something that has been seen in observational studies and that now will have to be tested with experimental studies in which, by increasing this lean mass, an improvement in cardiovascular health is seen .David: The data obtained in the study suggest the importance of lean mass in cardiac function in women. Lean mass is basically muscle mass and it can be changed. If we are talking about very old women, it may be more difficult, but it can be increased with weight-bearing exercises or similar, in more serious cases it could be modified through drugs. The data suggests that there is a very strong correlation between lean mass and cardiovascular health in women, independent of other variables. In fact, cardiologists are quite convinced that a woman’s lean mass determines heart function and cardiovascular health, although it remains to be proven. The more muscle mass a woman has, the more ability her heart has to pump blood. So, a healthy heart in a strong woman, and in a man? David: Men’s hearts are different from women’s, it’s what we call heart dimorphism, intrinsic differences between men and women. The woman’s heart is not only smaller, but has a different composition and adaptation. A better adaptation of the heart is associated with a longer life expectancy and better cardiovascular health, and is achieved when the heart becomes large and distensible at the same time, it is the typical heart of endurance athletes. In women, there is a higher proportion than men who do not adapt well to resistance training, because instead of having a larger and more distensible heart, it tends to be a stronger heart, as if it were hypertrophied, and this does not It is good from a health point of view. Candela: Historically, when we looked at the cardiovascular system, no one had ever looked at the periphery, at the muscles, because it was thought that they were not decisive in how much blood the heart can pump. The surprise of this study is that we have seen that in women it is a linear function, the more lean mass (the more muscle) they have, the more capacity of the heart to pump blood. This was not at all expected because everything that was known was based on studies in men. Q. What medical applications and implications could what was discovered have? Candela and David: There are cardiologists who claim that the results of our study could explain why the heart of women does not adapt as well to aerobic exercise as that of men. In addition, there are millions of women affected by a type of heart failure that is not known how to treat and that can be explained in part by a lack of muscle mass, lean mass. There are two renowned cardiologists from the United States who assure that the results of this study can make us understand, to a large extent, this pathology that at the moment we know little about: heart failure with preserved ejection fraction. There is a lot of research on it, but at the moment it is not very well known why it is due, and this may be part of the answer. P. The scientific press that has published your study also highlights your way of taking the samples. Candela: Yes, the data collection was done mostly in Calgary (Canada). For almost two years we have been analyzing the hearts of the participants thanks to a machine made by an engineer and designed by us. It is a pressure machine in a supine position (lying on the back) with a bike inside. In this way, with an echocardiograph, the situation at rest and at maximum effort was measured in healthy men and women between 20 and 70 years of age. In principle it was going to be a study to observe the differences between men and women in terms of aerobic capacity and cardiovascular function, but it was discovered that lean mass or muscle mass can be decisive in women, something that will have to be tested with experimental studies in the future. David: Different professionals from all over the world have participated in the study, but it is true that if it has gone ahead it has been thanks to Candela. She was the one who got a scholarship and opted for this type of research, despite the fact that much more molecular topics are financed in science because it is considered that in physiology everything is already known, but it is clear that in physiology of the heart not everything is seen . P. How is it that two Spaniards, graduates in sports sciences, end up dedicating themselves to scientific research in Hong Kong? Candela: It is true that it is not usual, especially in Spain, where the career focuses more on being a teacher than to dedicate yourself to research. Myself, in fact, when I finished I was working out in a gym. But then I bet on what I like. You have to work hard and be willing to make sacrifices, because a scientific career is not always easy. I went to Switzerland to do my doctorate. There I met David and together we have developed several research projects over the years. In Switzerland, in Canada, now we’ve met again here… David: I was a basketball player and I left Spain soon. I’ve been out for 20 years now. I started INEF, Sports Sciences, in Elche, but I ended up in France where the degree is more focused on understanding and researching the human body than in Spain. I was studying and researching in Italy, France, Switzerland, Calgary… and now in Hong Kong, one of the best universities in the world, especially in Medicine. It gives us many opportunities and freedom of investigation, and here we are: working and learning a culture that is a major shock, especially when nothing is known about Asia, as was the case with me. A scientific career is not always easy, especially for a woman, but, in the end, it pays off. And now, what, what are the next steps that you would like to take?Candela: In reference to the study, now it is time to do an experimental trial to demonstrate what was observed and to know what type of intervention can improve certain types of cardiovascular diseases in women , or what kind of drugs can regulate different proteins that play a protective role. On a personal level, to continue dedicating myself to science, which is what makes me happy. Because it’s not always easy, and less so for a woman, who until she reaches a certain stability has a hard time thinking about things like motherhood, but in the end it pays off, especially when you discover things with studies like this one. David: I’m happy to be the one asking the questions and having the means to answer them, having that freedom. If it could be closer to home, then perfect, but it is true that it is not easy. Q. Do you consider yourself part of the lost Spanish scientific talent? Candela and David: As a researcher, it’s good that you go out and train. That is not a loss. Spain has provided us with an education and a culture, and it also has a lot of unprecedented talent. What should be done is to have more ambition not only to recover national talent, but also to attract talent from other countries, making universities more international. If there were scientific projects and a certain stability, many of us who are abroad would return, because we like life in Spain, that’s for sure!