P3483Gender differences of clinical course and myocardial remodeling in elderly patients with idiopathic hypertrophic cardiomyopathy

Aim: To study gender differences of clinical course and myocardial remodeling in elderly patients with idiopathic hypertrophic cardiomyopathy (HCM). Materials and methods: The study included 131 patients with idiopathic HCM. Patients underwent standard clinical, laboratory and instrumental diagnostic methods. Results: In the elderly patients with idiopathic HCM, the proportion of females was 63% (n=82), males - 37% (n=49). The average age of females was 69±7 years, males - 68±7 years. Coronary artery disease (CAD) was more common in males (32%) than in females (22%), but were found no statistically significant differences (p=0.20). Atrial fibrillation was more common in males (49% versus 29%, respectively, p=0.03). Size of left atrium and end-diastolic size of left ventricle in males exceeded those in females (51.2±9.0 mm versus 46.3±4.7 mm, 51.5±7.6 mm versus 45.6±5,7 mm, respectively, p=0.01). In males, a symmetrical myocardial remodeling was established more often (42% versus 25%, p=0.04). Obstructive form of HCM was predominant in females (45% and 14%, p=0.01). Chronic heart failure (CHF) in NYHA FC III was observed in 29% in female group (n=24) and in 12% in male group (n=6), which tends to differ (p=0.06). In females CHF in NYHA FC III was mainly due to left ventricle outflow tract obstruction (n=13) and dilatation phase (n=3). In males, almost all cases of CHF in NYHA FC III–IV (8 from 9 patients) were as a result of a combination of HCM with CAD and previous myocardial infarction. In males, the ejection fraction was significantly lower (55.7±14.8% versus 62.2±10.9%, p=0.01).