Women with HCM had significantly higher rates of hospitalization for heart failure, arrhythmias, or stroke compared to men (34.4% vs. 24.4%, p<0.03) despite having fewer symptoms at baseline.
Cohort (n=501)
Do clinical features, myocardial mechanics, and long-term outcomes differ between women and men with hypertrophic cardiomyopathy?
Women with HCM exhibit distinct structural and mechanical features, including smaller ventricular size and impaired myocardial deformation, which are associated with increased morbidity compared to men.
Tasa de eventos absoluta: 34.4% vs 24.4%
valor p: p=<0.03
ABSTRACT Background Sex‐related differences in hypertrophic cardiomyopathy (HCM) are increasingly recognized, yet women remain underrepresented in most cohorts. This study aimed to characterize sex‐specific differences in clinical features, myocardial mechanics, and long‐term outcomes, with a focus on distinctive characteristics in women with HCM. Methods We studied 501 patients with HCM who underwent comprehensive clinical and echocardiographic evaluation between August 2010 and July 2017; 181 (36%) were women. Survival and event‐free outcomes were assessed during a median follow‐up of 6.23 years (range: 2.8–9.25 years) using Kaplan–Meier analysis and the log‐rank test. Results At baseline, women were more likely to have familial HCM and were less symptomatic (NYHA class, p < 0.01) but had higher heart rate ( p < 0.001), smaller LV end‐diastolic and end‐systolic diameters, and lower LV mass index (LVMI) than men. Women demonstrated higher E/E′ ratio ( p < 0.03), increased pulmonary artery systolic pressure ( p < 0.03), reduced global longitudinal strain (GLS) (−10.6 ± 4.7 vs. −12.0 ± 5.1, p < 0.003), and lower early diastolic strain rate (SRe, P < 0.0001). Hospitalizations for heart failure, arrhythmias, or stroke were more frequent in women (34.4% vs. 24.4%, p < 0.03). Kaplan–Meier analysis showed a nonsignificant trend toward poorer survival in women. Cox regression analysis identified age as an independent predictor of hospitalization, while LV end‐diastolic diameter, S′ velocity, independently predicted mortality. Conclusions Women with HCM exhibit distinct structural and mechanical features, including smaller ventricular size, lower LV mass, higher filling pressures, and impaired myocardial deformation. These differences are associated with increased morbidity and support the need for sex‐specific diagnostic thresholds and individualized management strategies. Key Findings In this cohort of 501 patients with HCM, women exhibited smaller ventricles, higher filling pressures, and more impaired myocardial deformation despite fewer symptoms. These sex‐specific structural and functional differences were associated with increased hospitalizations and highlight the need for tailored diagnostic thresholds and management strategies in women.
Badran et al. (Tue,) conducted a cohort in Hypertrophic cardiomyopathy (HCM) (n=501). Female sex vs. Male sex was evaluated on Hospitalizations for heart failure, arrhythmias, or stroke (p=<0.03). Women with HCM had significantly higher rates of hospitalization for heart failure, arrhythmias, or stroke compared to men (34.4% vs. 24.4%, p<0.03) despite having fewer symptoms at baseline.