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Published on: August 8, 2022
Gender and age predict advanced heart failure in gene-negative patients with hypertrophic cardiomyopathy
Fangfang Ji1, Xueshou Yu2, Wenxu Sheng2
1Shandong Provincial Chronic Disease Hospital, Qingdao, China.
Insights
Female gender and older age are key predictors of advanced heart failure (HF) in hypertrophic cardiomyopathy (HCM) patients without genetic mutations. Early intervention is vital for managing these high-risk individuals.
Area of Science:
- Cardiology
- Genetics
- Heart Failure Research
Background:
- Hypertrophic cardiomyopathy (HCM) can lead to advanced heart failure (HF).
- Limited data exists on outcomes for gene-negative HCM patients with advanced HF.
- Identifying prognostic factors is crucial for this specific patient group.
Purpose of the Study:
- To identify prognostic factors for advanced HF in gene-negative patients within a large HCM cohort.
- To determine risk factors associated with the development of advanced HF in this population.
Main Methods:
- Genotyping via whole exome or panel sequencing was performed on 1529 HCM patients.
- A subset of 735 gene-negative patients were analyzed for advanced HF development.
- Multivariable Cox proportional hazards regression identified risk factors.
Main Results:
- Among 735 gene-negative HCM patients, 13.2% developed advanced HF over a mean follow-up of 3.2 years.
- Female gender (aHR 2.499) and older age at enrollment (aHR 1.298) were significant risk factors for advanced HF.
- These findings highlight specific demographic groups at higher risk.
Conclusions:
- Female gender and older age are potential predictors of advanced HF in gene-negative HCM patients.
- Early detection and proactive management are essential for improving outcomes.
- Further research may refine risk stratification and treatment strategies.
Background:
Patients with hypertrophic cardiomyopathy (HCM) may develop concomitant advanced heart failure (HF). However, there is limited data on the clinical outcomes of HCM patients without sarcomere gene mutations who have advanced HF.
Objectives:
To identify prognostic factors for advanced HF in gene-negative patients within a large HCM cohort.
Methods:
A total of 1529 unrelated patients with HCM were enrolled between 1999 and 2018, and followed throughout the study period. All patients underwent genotyping through whole exome or panel sequencing. From this cohort, 735 patients without mutations were studied. We assessed the effects of family history, clinical findings, and echocardiographic parameters on the development of advanced HF. Multivariable Cox proportional hazards regression analysis was conducted to identify risk factors associated with advanced HF.
Results:
Of the 735 gene-negative patients studied, the mean age was 52.5±13.2 years, 69.5% were male, and the mean follow-up duration was 3.2±2.3 years. During this period, 97 patients (13.2%) developed advanced HF. Using multivariable analysis, we identified significant risk factors for advanced HF: female gender (adjusted hazard ratio [HR] 2.499, 95% confidence interval [CI] 1.531-4.081, P<0.001) and older age at enrollment (adjusted HR 1.298, 95% CI 1.00-1.682, P=0.049). These findings suggest that female patients and those enrolled at an older age are at a higher risk for developing advanced HF.
Conclusion:
Female gender and older age may predict a higher risk of advanced HF in gene-negative patients with HCM. Early detection and proactive treatment are crucial for managing and preventing complications in these patients.
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