■尽管人们越来越认识到性别会影响肥厚型心肌病(HCM)的表现和结果,这种关系在亚洲人中被研究不足。因此,我们旨在探讨亚洲HCM患者的性别差异。
■从2010年至2017年,从三级心脏病学中心招募了295名被诊断为HCM的连续患者,平均3.9±2.7年。我们评估了性别对亚洲患者HCM结局的影响。
■HCM患者更常见的是男性(72%)。女性年龄较大,有更多的合并症,包括高血压和心房颤动。经胸超声心动图,左心室收缩末期和舒张末期容积指数相似,但更多的女性患有中度以上的二尖瓣反流,并且左心室流出道(LVOT)较小.女性更常见的是有明显的LVOT梗阻的阻塞性生理学发现,定义为静息时>30mmHg。不同性别的植入式心律转复除颤器的使用相似。在多变量分析中,研究发现女性更有可能发生需要入院治疗的进行性心力衰竭(风险比[HR]2.10,95%置信区间[CI]1.05~4.71,P=0.021),但全因死亡率较低(HR0.36,95%CI0.19~0.70,P=0.003).
■被诊断为HCM的女性年龄较大,男性有更多的合并症,更有可能发生心力衰竭,而男性有更高的全因死亡风险。
UNASSIGNED: Despite the growing recognition that sex can affect the presentation and outcomes in hypertrophic cardiomyopathy (HCM), this relationship is understudied in Asians. Therefore, we aimed to explore sex differences in Asian patients with HCM.
UNASSIGNED: A total of 295 consecutive patients diagnosed with HCM were recruited from a tertiary cardiology centre from 2010 to 2017 over a mean of 3.9±2.7 years. We evaluated the effects of sex on the outcomes of HCM in Asian patients.
UNASSIGNED: HCM patients were more commonly men (72%). Women were older and had more comorbidities, including hypertension and atrial fibrillation. On transthoracic echocardiography, the indexed left ventricular end-systolic and end-diastolic volumes were similar, but more women had more-than-moderate mitral regurgitation and had a smaller left ventricular outflow tract (LVOT). Women more commonly had findings of obstructive physiology with significant LVOT obstruction, defined as >30 mmHg at rest. The use of implantable cardioverter defibrillators was similar across sexes. On multivariable analysis, women were found to be more likely to develop progressive heart failure requiring admission (hazard ratio [HR] 2.10, 95% confidence interval [CI] 1.05-4.71, P=0.021) but had a lower rate of all-cause mortality (HR 0.36, 95% CI 0.19-0.70, P=0.003).
UNASSIGNED: Women diagnosed with HCM were older, had more comorbidities and were more likely to develop heart failure while men had a higher risk of all-cause mortality.