PMID- 16053962
OWN - NLM
STAT- MEDLINE
DCOM- 20050830
LR  - 20220409
IS  - 0735-1097 (Print)
IS  - 0735-1097 (Linking)
VI  - 46
IP  - 3
DP  - 2005 Aug 2
TI  - Gender-related differences in the clinical presentation and outcome of 
      hypertrophic cardiomyopathy.
PG  - 480-7
AB  - OBJECTIVES: The goal of this study was to assess gender-related differences in a 
      multicenter population with hypertrophic cardiomyopathy (HCM). BACKGROUND: Little 
      is known regarding the impact of gender on the heterogeneous clinical profile and 
      clinical course of HCM. METHODS: We studied 969 consecutive HCM patients from 
      Italy and the U.S. followed over 6.2 +/- 6.1 years. RESULTS: Male patients had a 
      3:2 predominance (59%), similar in Italy and the U.S. (p = 0.24). At initial 
      evaluation, female patients were older and more symptomatic than male patients 
      (47 +/- 23 years vs. 38 +/- 18 years; p < 0.001; mean New York Heart Association 
      [NYHA] functional class 1.8 +/- 0.8 vs. 1.4 +/- 0.6; p < 0.001), and more 
      frequently showed left ventricular outflow obstruction (37% vs. 23%; p < 0.001). 
      Moreover, female patients were less often diagnosed fortuitously by routine 
      medical examination (23% vs. 41% in male patients, p < 0.001). Female gender was 
      independently associated with the risk of symptom progression to NYHA functional 
      classes III/IV or death from heart failure or stroke compared with male gender 
      (independent relative hazard 1.5; p < 0.001), particularly patients > or =50 
      years of age and with resting outflow obstruction (p < 0.005). Hypertrophic 
      cardiomyopathy-related mortality and risk of sudden death were similar in men and 
      women. CONCLUSIONS: Women with HCM were under-represented, older, and more 
      symptomatic than men, and showed higher risk of progression to advanced heart 
      failure or death, often associated with outflow obstruction. These 
      gender-specific differences suggest that social, endocrine, or genetic factors 
      may affect the diagnosis and clinical course of HCM. A heightened suspicion for 
      HCM in women may allow for timely implementation of treatment strategies, 
      including relief of obstruction and prevention of sudden death or stroke.
FAU - Olivotto, Iacopo
AU  - Olivotto I
AD  - Regional Referral Center for Myocardial Diseases, Azienda Ospedaliera 
      Universitaria Careggi, Florence, Italy. olivottoi@ao-careggi.toscana.it
FAU - Maron, Martin S
AU  - Maron MS
FAU - Adabag, A Selcuk
AU  - Adabag AS
FAU - Casey, Susan A
AU  - Casey SA
FAU - Vargiu, Daniela
AU  - Vargiu D
FAU - Link, Mark S
AU  - Link MS
FAU - Udelson, James E
AU  - Udelson JE
FAU - Cecchi, Franco
AU  - Cecchi F
FAU - Maron, Barry J
AU  - Maron BJ
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
SB  - IM
MH  - Adult
MH  - Age Distribution
MH  - Aged
MH  - Cardiomyopathy, Hypertrophic/diagnostic imaging/*epidemiology/*physiopathology
MH  - *Cause of Death
MH  - Cohort Studies
MH  - Disease Progression
MH  - Echocardiography, Doppler
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Prevalence
MH  - Probability
MH  - Proportional Hazards Models
MH  - Severity of Illness Index
MH  - Sex Distribution
MH  - Survival Analysis
MH  - United States/epidemiology
MH  - Ventricular Outflow Obstruction/diagnostic imaging/*epidemiology/*physiopathology
EDAT- 2005/08/02 09:00
MHDA- 2005/09/01 09:00
CRDT- 2005/08/02 09:00
PHST- 2004/12/07 00:00 [received]
PHST- 2005/01/20 00:00 [revised]
PHST- 2005/04/13 00:00 [accepted]
PHST- 2005/08/02 09:00 [pubmed]
PHST- 2005/09/01 09:00 [medline]
PHST- 2005/08/02 09:00 [entrez]
AID - S0735-1097(05)01023-5 [pii]
AID - 10.1016/j.jacc.2005.04.043 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2005 Aug 2;46(3):480-7. doi: 10.1016/j.jacc.2005.04.043.