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Sex-related differences in symptomatic patients with hypertrophic obstructive cardiomyopathy - Time for a new

Angelika Batzner1, Diaa Aicha2, Barbara Pfeiffer2

  • 1Comprehensive Heart Failure Center (CHFC), University Clinic, Wuerzburg, Germany; Medizinische Klinik 1, Leopoldina-Krankenhaus, Schweinfurt, Germany.

International Journal of Cardiology
|December 28, 2020
PubMed

Insights

Women with hypertrophic obstructive cardiomyopathy (HOCM) are diagnosed later and present with more advanced symptoms. Increased awareness and revised diagnostic criteria are needed to ensure timely treatment for HOCM in women.

Area of Science:

  • Cardiology
  • Medical Diagnostics
  • Gender-Specific Medicine

Background:

  • Sex-related differences in hypertrophic obstructive cardiomyopathy (HOCM) diagnosis and treatment remain unclear.
  • Understanding these differences is crucial for effective patient management.

Purpose of the Study:

  • To analyze baseline characteristics of symptomatic patients with hypertrophic obstructive cardiomyopathy (HOCM) indicated for alcohol septal ablation (PTSMA), focusing on gender-based variations.
  • To identify potential disparities in HOCM presentation and progression between men and women.

Main Methods:

  • Retrospective analysis of 1014 patients (420 women, 594 men) who underwent PTSMA between May 2000 and June 2017.
  • Comparison of demographic, clinical, and echocardiographic parameters between female and male HOCM patients.

Main Results:

  • Women were older (61.4 vs. 51.8 years) and more frequently presented with severe dyspnea (NYHA III/IV).
  • While echocardiographic gradients were similar, women had smaller absolute left atrial diameter, septal thickness, and left ventricular posterior wall thickness.
  • When indexed for body surface area (BSA), these dimensions were larger in women, indicating more significant relative cardiac changes.

Conclusions:

  • Women with HOCM indicated for PTSMA are older and present with more advanced disease.
  • Delayed diagnosis and treatment in women may result from current disease definitions and a lack of awareness.
  • Reconsideration of HOCM diagnostic criteria and increased clinical awareness are necessary for equitable care.
Abstract

Keywords:
AwarenessHypertrophic obstructive cardiomyopathyIndexed echocardiographic measurementsSex-related differenceWomen

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