Following septal myectomy for obstructive hypertrophic cardiomyopathy, women and men had similar rates of the composite endpoint (8% vs 15%, p>0.05) over 5.9 years of follow-up.
Cohort (n=162)
Does sex impact the timing and clinical outcome of septal myectomy in patients with obstructive hypertrophic cardiomyopathy?
Although women with obstructive HCM present for septal myectomy at an older age and with more advanced echocardiographic disease, their long-term clinical outcomes are favorable and similar to men.
Absolute Event Rate: 8% vs 15%
p-value: p=>0.05
BackgroundSex disparities are common in hypertrophic cardiomyopathy (HCM). Previous research has shown that at time of myectomy, women are older, have greater impairment of diastolic function and more advanced cardiac remodeling. The clinical impact of these differences is unknown.MethodThis study included 162 HCM patients (61% men) who underwent septal myectomy. Time to treatment was calculated in relation to symptom onset and diagnosis. Pre- and post-operative echocardiographic data were collected. Sex differences were assessed at baseline and in time-to-event survival analyses for the composite endpoint of all-cause mortality, cardiac transplantation, re-intervention and aborted sudden cardiac death.ResultsWomen were generally older at time of myectomy (57 vs. 49 years, p 0.05), but a shorter time since diagnosis compared to men (2.6 1.2–7.0 vs. 4.3 2.4–8.3 years, p = 0.02). Mean wall thickness and left atrial diameter were the same for men and women, but were higher in women when correcting for body surface area (absolute: 20 vs. 19 mm, 48 vs 46 mm, p ≥ 0.05; corrected: 9.7 vs. 11.2 mm/m2, 23.4 vs. 26.3 mm/m2, p 0.05).ConclusionIn conclusion, although women present later in life and seem to have more advanced disease on echocardiography, time until myectomy was similar and clinical outcomes after myectomy are favourable for both men and women.
Huurman et al. (Sat,) conducted a cohort in Obstructive hypertrophic cardiomyopathy (n=162). Septal myectomy in women vs. Septal myectomy in men was evaluated on Composite of all-cause mortality, cardiac transplantation, re-intervention and aborted sudden cardiac death (p=>0.05). Following septal myectomy for obstructive hypertrophic cardiomyopathy, women and men had similar rates of the composite endpoint (8% vs 15%, p>0.05) over 5.9 years of follow-up.