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Gender-correlated differences in a population with hypertrophic cardiomyopathy. A portuguese multicenter study.

Session Up-to-date research on left ventricular function

Speaker Liliana Reis

Congress : EuroEcho-Imaging 2017

  • Topic : arrhythmias and device therapy
  • Sub-topic : Hypertrophic Cardiomyopathy
  • Session type : Rapid Fire Abstracts
  • FP Number : 37

Authors : L Reis (Coimbra,PT), J Bispo (Faro,PT), B Marmelo (Viseu,PT), M Oliveira (Guimaraes,PT), R Santos (Penafiel,PT), K Domingues (Santarem,PT), R Faria (Guimaraes,PT), A Marreios (Faro,PT), N Marques (Faro,PT)

Authors:
L Reis1 , J Bispo2 , B Marmelo3 , M Oliveira4 , R Santos5 , K Domingues6 , R Faria4 , A Marreios7 , N Marques2 , 1University Hospitals of Coimbra - Coimbra - Portugal , 2Faro Hospital - Faro - Portugal , 3Hospital Sao Teotonio - Viseu - Portugal , 4Hospital Guimaraes - Guimaraes - Portugal , 5Hospital Centre do Tamega e Sousa - Penafiel - Portugal , 6Hospital of Santarem - Santarem - Portugal , 7Faro Hospital, Algarve biomedical center, Statistics - Faro - Portugal ,

On behalf: Sunshine

Citation:
European Heart Journal Supplements ( 2017 ) 18 ( Supplement 3 ), iii4

Introduction: Hypertrophic cardiomyopathy (HCM) is a genetic cardiac disease characterized by extreme heterogeneity in clinical expression. This disorder is caused by cardiac sarcomeric protein genes mutations and is most frequently transmitted as an autosomal dominant trait. Since gender plays an important role in the clinical expression and prognosis of various cardiovascular diseases. Little is known regarding the impact of gender in this disease. We aim to assess gender-related differences in a population with HCM.

Methods: Portuguese retrospective study, comprising 567 patients diagnosed with HMC in 12 hospitals. There were evaluated clinical, genetic, electrocardiographic, echocardiographic and magnetic resonance parameters. Mean follow-up duration was 8.0±6.1 years, no difference in length between male (M) and female (F) was found. The clinical endpoints of interest were dysrhythmic events, stroke, cardiovascular mortality and all cause mortality.

Results: The main characteristics by gender, at presentation, are listed in table 1.
At initial evaluation, F patients were older and more symptomatic than M patients. No gender differences were observed in genetic, electrocardiographic and echocardiographic parameters. Regarding CMR parameters, late enhancement was more prevalent in M patients (51% vs 67%, p=0.04).
Although F were more symptomatic, there were no differences in progression to chronic heart failure, medical treatment, implantation of ICD, dysrhythmic events, stroke and all cause mortality. HCM-related mortality and risk of sudden death were similar in men and women. After adjusting for age, NYHA functional class and late enhancement, no differences were observed between genders.

Conclusion: As previously reported on HCM, women are older, more symptomatic and have worse prognosis. But unlike the other studies, in our population, the female gender was not associated with a worse prognosis.

Evaluation

Overall

Male patients

Female patients

P value

Number, N (%)

567

333 (59%)

234 (41%)

Age (years)

567

59 ± 15

67 ± 15

0.02

Type of MCH, N (%)

- Assymmetric

- Symmetric

- Apical

344

72

83

209 (63%)

43 (13%)

42 (13%)

135 (58%)

29 (12%)

41 (18%)

0.22

0.86

0.10

LVOT, N (%)

140

76 (23%)

64 (27%)

0.22

NYHA class>II, N (%)

567

158 (47%)

166 (71%)

<0.0001

Late enhancement, N (%)

197

128 (67%)

69 (51%)

0.04



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