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Background. Cardiac masses (CM) represent a heterogeneous clinical scenario, and sex-related differences of these patients remain to be established. Purpose: To evaluate sex-related disparities in CMs regarding clinical presentation and outcomes. Material and Methods. The study cohort included 321 consecutive patients with CM enrolled in our Centre between 2004 and 2022. A definitive diagnosis was achieved by histological examination or, in the case of cardiac thrombi, with radiological evidence of thrombus resolution after anticoagulant treatment. All-cause mortality at follow-up was evaluated. Multivariable regression analysis assessed the potential prognostic disparities between men and women. Results. Out of 321 patients with CM, 172 (54%) were female. Women were more frequently younger (p = 0.02) than men. Regarding CM histotypes, females were affected by benign masses more frequently (with cardiac myxoma above all), while metastatic tumours were more common in men (p < 0.001). At presentation, peripheral embolism occurred predominantly in women (p = 0.03). Echocardiographic features such as greater dimension, irregular margin, infiltration, sessile mass and immobility were far more common in men. Despite a better overall survival in women, no sex-related differences were observed in the prognosis of benign or malignant masses. In fact, in multivariate analyses, sex was not independently associated with all-cause death. Conversely, age, smoking habit, malignant tumours and peripheral embolism were independent predictors of mortality. Conclusions. In a large cohort of cardiac masses, a significant sex-related difference in histotype prevalence was found: Benign CMs affected female patients more frequently, while malignant tumours affected predominantly men. Despite better overall survival in women, sex did not influence prognosis in benign and malignant masses.

The bio-accessibility (the release of compounds from solid food matrices) of grape polyphenols using an in vitro model simulating gastro-intestinal conditions has been investigated. In vitro studies are needed to unravel factors affecting the release of antioxidants during digestion. The amount of bio-accessible polyphenols, flavonoids and anthocyanins increases during gastric digestion. The transition in the intestinal environment causes a decrease in all the analyzed classes of polyphenols followed by a renewal in the extraction of polyphenols and flavonoids but not of anthocyanins. The stability under gastro-intestinal conditions of pure phenolic acids, flavonoids and resveratrol has been analysed. Gastric digestion had no effect on any phenolic tested. Phenolic acids and resveratrol were degraded under pancreatic conditions whereas catechin and quercetin were not. Changes in antioxidant activity during digestion were correlated to the changes in polyphenols concentration as well as to the pH. Our results suggest that the gastro-intestinal tract may act as an extractor where polyphenols are progressively released from solid matrix and made available for the absorption or to exert their biological effects in the gastro-intestinal tract.