PMID- 32611501 OWN - NLM STAT- MEDLINE DCOM- 20210512 LR - 20211204 IS - 1444-2892 (Electronic) IS - 1443-9506 (Linking) VI - 29 IP - 12 DP - 2020 Dec TI - Gender Disparities in Clinical Outcome After Alcohol Septal Ablation for Hypertrophic Obstructive Cardiomyopathy in the Chinese Han Population: A Cohort Study. PG - 1856-1864 LID - S1443-9506(20)30240-7 [pii] LID - 10.1016/j.hlc.2020.04.014 [doi] AB - BACKGROUND: Sex differences in the long-term prognosis of symptomatic hypertrophic obstructive cardiomyopathy (HOCM) patients undergoing alcohol septal ablation (ASA) remain unclear, especially in the Chinese Han population. METHOD: This cohort study included 320 HOCM Chinese Han patients who underwent ASA because of symptomatic left ventricular outflow tract (LVOT) obstruction. Patients were grouped according to sex: females (mean+/-standard deviation age [SD] 50.7+/-6.8 years) and males (mean+/-SD age 52.6+/-7.3 years). Individuals were followed over the long term. RESULTS: Pre-procedure, women had more symptoms (New York Heart Association [NYHA] class III-IV 67.3% vs 56.3%, p=0.03), more atrial fibrillation (23.5% vs 14.6%, p=0.047) than men. Transient complete atrioventricular block after ASA was more common in woman than in men (34.0 vs 23.4%; p=0.048). Residual LVOT gradient, post-procedural residual left ventricular wall thickness, NYHA functional class, and adverse arrhythmic events were comparable between the two groups. The 10-year survival rate (77% vs 89%, p=0.037) and the annual adverse arrhythmic event rate (1.3% vs 0.4%, p<0.01) following ASA were significantly worse in women compared with men. Kaplan-Meier analysis showed a significantly lower survival in women compared with men (p=0.023). In multivariable modelling, female sex remained independently associated with higher all-cause mortality (hazard ratio, 1.12; 95% confidence interval, 1.08-1.27; p=0.03) when adjusted for age, NYHA class III-IV symptoms, and other cardiovascular comorbidities. CONCLUSIONS: Female patients with HOCM undergoing ASA tended to have more severe symptoms and adverse arrhythmic events. The 10-year survival rate after ASA was significantly worse in women compared with men with HOCM. Sex may need to be considered as an important factor in the clinical management of patients with symptomatic HOCM. CI - Copyright (c) 2020 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved. FAU - Wang, Yong AU - Wang Y AD - Department of Cardiology, The People's Hospital of China Medical University, The People's Hospital of Liaoning Province, Shenyang, Liaoning Province, P. R. China. FAU - Zhao, Hong-Wei AU - Zhao HW AD - Department of Cardiology, The People's Hospital of China Medical University, The People's Hospital of Liaoning Province, Shenyang, Liaoning Province, P. R. China. FAU - Wang, Cheng-Fu AU - Wang CF AD - Department of Cardiology, The People's Hospital of China Medical University, The People's Hospital of Liaoning Province, Shenyang, Liaoning Province, P. R. China. FAU - Meng, Qing-Kun AU - Meng QK AD - Department of Cardiology, The People's Hospital of China Medical University, The People's Hospital of Liaoning Province, Shenyang, Liaoning Province, P. R. China. FAU - Cui, Chun-Sheng AU - Cui CS AD - Department of Cardiology, The People's Hospital of China Medical University, The People's Hospital of Liaoning Province, Shenyang, Liaoning Province, P. R. China. FAU - Zhang, Xiao-Jiao AU - Zhang XJ AD - Department of Cardiology, The People's Hospital of China Medical University, The People's Hospital of Liaoning Province, Shenyang, Liaoning Province, P. R. China. FAU - Zhu, Yu AU - Zhu Y AD - Department of Cardiology, The People's Hospital of China Medical University, The People's Hospital of Liaoning Province, Shenyang, Liaoning Province, P. R. China. FAU - Fan, Chun-Yu AU - Fan CY AD - Department of Cardiology, The People's Hospital of China Medical University, The People's Hospital of Liaoning Province, Shenyang, Liaoning Province, P. R. China. FAU - Luo, De-Feng AU - Luo DF AD - Department of Cardiology, The People's Hospital of China Medical University, The People's Hospital of Liaoning Province, Shenyang, Liaoning Province, P. R. China. FAU - Chen, Bao-Jun AU - Chen BJ AD - Department of Cardiology, The People's Hospital of China Medical University, The People's Hospital of Liaoning Province, Shenyang, Liaoning Province, P. R. China. FAU - Luan, Bo AU - Luan B AD - Department of Cardiology, The People's Hospital of China Medical University, The People's Hospital of Liaoning Province, Shenyang, Liaoning Province, P. R. China. Electronic address: luanbo2016@163.com. FAU - Hou, Ai-Jie AU - Hou AJ AD - Department of Cardiology, The People's Hospital of China Medical University, The People's Hospital of Liaoning Province, Shenyang, Liaoning Province, P. R. China. Electronic address: 1758624242@qq.com. LA - eng PT - Journal Article DEP - 20200611 PL - Australia TA - Heart Lung Circ JT - Heart, lung & circulation JID - 100963739 RN - 3K9958V90M (Ethanol) SB - IM MH - Ablation Techniques/*methods MH - Cardiomyopathy, Hypertrophic/diagnosis/*ethnology/therapy MH - China/epidemiology MH - Ethanol/*pharmacology MH - *Ethnicity MH - Female MH - Follow-Up Studies MH - Heart Septum/*drug effects MH - Humans MH - Male MH - Middle Aged MH - Retrospective Studies MH - Time Factors MH - Treatment Outcome OTO - NOTNLM OT - Alcohol septal ablation OT - Gender disparity OT - Hypertrophic obstructive cardiomyopathy OT - Long-term prognosis OT - Sex differences EDAT- 2020/07/03 06:00 MHDA- 2021/05/13 06:00 CRDT- 2020/07/03 06:00 PHST- 2019/08/17 00:00 [received] PHST- 2020/04/01 00:00 [revised] PHST- 2020/04/26 00:00 [accepted] PHST- 2020/07/03 06:00 [pubmed] PHST- 2021/05/13 06:00 [medline] PHST- 2020/07/03 06:00 [entrez] AID - S1443-9506(20)30240-7 [pii] AID - 10.1016/j.hlc.2020.04.014 [doi] PST - ppublish SO - Heart Lung Circ. 2020 Dec;29(12):1856-1864. doi: 10.1016/j.hlc.2020.04.014. Epub 2020 Jun 11.