PMID- 29020402
OWN - NLM
STAT- MEDLINE
DCOM- 20180806
LR  - 20220316
IS  - 1522-9645 (Electronic)
IS  - 0195-668X (Print)
IS  - 0195-668X (Linking)
VI  - 38
IP  - 46
DP  - 2017 Dec 7
TI  - Women with hypertrophic cardiomyopathy have worse survival.
PG  - 3434-3440
LID - 10.1093/eurheartj/ehx527 [doi]
AB  - AIMS: Sex differences in hypertrophic cardiomyopathy (HCM) remain unclear. We 
      sought to characterize sex differences in a large HCM referral centre population. 
      METHODS AND RESULTS: Three thousand six hundred and seventy-three adult patients 
      with HCM underwent evaluation between January 1975 and September 2012 with 1661 
      (45.2%) female. Kaplan-Meier survival curves were assessed via log-rank test. Cox 
      proportional hazard regression analyses evaluated the relation of sex with 
      survival. At index visit, women were older (59 +/- 16 vs. 52 +/- 15 years, 
      P < 0.0001) had more symptoms [New York Heart Association (NYHA) Class III-IV 
      45.0% vs. 35.3%, P < 0.0001], more obstructive physiology (77.4% vs. 71.8%, 
      P = 0.0001), more mitral regurgitation (moderate or greater in 56.1% vs. 43.9%, 
      P < 0.0001), higher E/e' ratio (n = 1649, 20.6 vs. 15.6, P < 0.0001), higher 
      estimated pulmonary artery systolic pressure (n = 1783, 40.8 +/- 15.4 vs. 
      34.8 +/- 10.8 mmHg, P < 0.0001), worse cardiopulmonary exercise performance 
      (n = 1267; percent VO2 predicted 62.8 +/- 20% vs. 65.8 +/- 19.2%, P = 0.007), and 
      underwent more frequent alcohol septal ablation (4.9% vs. 3.0%, P = 0.004) but 
      similar frequency of myectomy (28% vs. 30%, P = 0.24). Median follow-up was 10.9 
      (IQR 7.4-16.2) years. Kaplan-Meier analysis demonstrated lower survival in women 
      compared with men (P < 0.0001). In multivariable modelling, female sex remained 
      independently associated with mortality (HR 1.13 [1.03-1.22], P = 0.01) when 
      adjusted for age, NYHA Class III-IV symptoms, and cardiovascular comorbidities. 
      CONCLUSION: Women with HCM present at more advanced age, with more symptoms, 
      worse cardiopulmonary exercise tolerance, and different haemodynamics than men. 
      Sex is an important determinant in HCM management as women with HCM have worse 
      survival. Women may require more aggressive diagnostic and therapeutic 
      approaches.
CI  - Published on behalf of the European Society of Cardiology. All rights reserved. (c) 
      The Author 2017. For permissions, please email: journals.permissions@oup.com.
FAU - Geske, Jeffrey B
AU  - Geske JB
AD  - Department of Cardiovascular Diseases, Mayo Clinic, 200 First St. S.W., 
      Rochester, MN 55905, USA.
FAU - Ong, Kevin C
AU  - Ong KC
AD  - Department of Cardiovascular Diseases, Mayo Clinic, 200 First St. S.W., 
      Rochester, MN 55905, USA.
FAU - Siontis, Konstantinos C
AU  - Siontis KC
AD  - Department of Internal Medicine, Mayo Clinic, 200 First St. S.W., Rochester, MN 
      55905, USA.
FAU - Hebl, Virginia B
AU  - Hebl VB
AD  - Department of Cardiovascular Diseases, Mayo Clinic, 200 First St. S.W., 
      Rochester, MN 55905, USA.
FAU - Ackerman, Michael J
AU  - Ackerman MJ
AD  - Department of Cardiovascular Diseases, Mayo Clinic, 200 First St. S.W., 
      Rochester, MN 55905, USA.
AD  - Department of Pediatrics, Mayo Clinic, 200 First St. S.W., Rochester, MN 55905, 
      USA.
AD  - Department of Molecular Pharmacology & Experimental Therapeutics, Mayo Clinic, 
      200 First St. S.W., Rochester, MN 55905, USA.
FAU - Hodge, David O
AU  - Hodge DO
AD  - Department of Biomedical Statistics and Informatics, Mayo Clinic, 200 First St. 
      S.W., Rochester, MN 55905, USA.
FAU - Miller, Virginia M
AU  - Miller VM
AD  - Women's Health Research Center, Mayo Clinic, 200 First St. S.W., Rochester, MN 
      55905, USA.
FAU - Nishimura, Rick A
AU  - Nishimura RA
AD  - Department of Cardiovascular Diseases, Mayo Clinic, 200 First St. S.W., 
      Rochester, MN 55905, USA.
FAU - Oh, Jae K
AU  - Oh JK
AD  - Department of Cardiovascular Diseases, Mayo Clinic, 200 First St. S.W., 
      Rochester, MN 55905, USA.
FAU - Schaff, Hartzell V
AU  - Schaff HV
AD  - Department of Cardiovascular Surgery, Mayo Clinic, 200 First St. S.W., Rochester, 
      MN 55905, USA.
FAU - Gersh, Bernard J
AU  - Gersh BJ
AD  - Department of Cardiovascular Diseases, Mayo Clinic, 200 First St. S.W., 
      Rochester, MN 55905, USA.
FAU - Ommen, Steve R
AU  - Ommen SR
AD  - Department of Cardiovascular Diseases, Mayo Clinic, 200 First St. S.W., 
      Rochester, MN 55905, USA.
LA  - eng
GR  - P50 AG044170/AG/NIA NIH HHS/United States
PT  - Journal Article
PL  - England
TA  - Eur Heart J
JT  - European heart journal
JID - 8006263
SB  - IM
CIN - Eur Heart J. 2017 Dec 7;38(46):3441-3433. PMID: 29165548
MH  - Ablation Techniques/mortality/statistics & numerical data
MH  - Cardiomyopathy, Hypertrophic/*mortality/therapy
MH  - Echocardiography
MH  - Female
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Middle Aged
MH  - Minnesota/epidemiology
MH  - Proportional Hazards Models
MH  - Sex Distribution
PMC - PMC6251550
OTO - NOTNLM
OT  - Female
OT  - Gender
OT  - Hypertrophic cardiomyopathy
OT  - Male
OT  - Sex
EDAT- 2017/10/12 06:00
MHDA- 2018/08/07 06:00
PMCR- 2018/12/07
CRDT- 2017/10/12 06:00
PHST- 2017/03/29 00:00 [received]
PHST- 2017/08/21 00:00 [accepted]
PHST- 2017/10/12 06:00 [pubmed]
PHST- 2018/08/07 06:00 [medline]
PHST- 2017/10/12 06:00 [entrez]
PHST- 2018/12/07 00:00 [pmc-release]
AID - 4107905 [pii]
AID - ehx527 [pii]
AID - 10.1093/eurheartj/ehx527 [doi]
PST - ppublish
SO  - Eur Heart J. 2017 Dec 7;38(46):3434-3440. doi: 10.1093/eurheartj/ehx527.