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Sex-Specific Differences in Patients with Hypertrophic Cardiomyopathy: A Cohort Study from Vienna
Christopher Mann1, Rodi Tosun1, Shehroz Masood1
1Department of Medicine II, Division of Cardiology, Medical University of Vienna, 1090 Vienna, Austria.
Journal of Personalized Medicine
|January 27, 2026
Summary
Women with hypertrophic cardiomyopathy (HCM) are diagnosed later, presenting with more severe symptoms and obstructive physiology. Recognizing these sex-specific differences in HCM is vital for improved diagnosis and tailored treatment.
Area of Science:
- Cardiology
- Genetics
- Internal Medicine
Background:
- Hypertrophic cardiomyopathy (HCM) is a common inherited cardiovascular disease, more prevalent in males.
- Previous research indicates women with HCM face delayed diagnosis, advanced disease stages, pronounced symptoms, and poorer outcomes.
Purpose of the Study:
- To investigate sex-specific differences in clinical, laboratory, and imaging characteristics of HCM patients.
- To analyze data from a contemporary cohort at a tertiary referral center in Austria.
Main Methods:
- Retrospective analysis of 321 HCM patients from a prospective registry (2018-2024).
- Comprehensive baseline evaluation including medical history, lab tests, echocardiography, and cardiac MRI.
Main Results:
- Women diagnosed with HCM were older (62 vs. 53 years) and presented with more advanced symptoms (NYHA ≥ II: 80% vs. 49%).
- Obstructive HCM was more prevalent in women (55% vs. 32%), with lower 6-minute walking distance (425 vs. 505 m).
- Women showed higher diastolic filling pressures (E/E' 18 vs. 10), larger indexed atrial volumes, higher LVEF (70% vs. 62%), increased septal thickness, and elevated NT-proBNP (760 vs. 338 pg/L).
Conclusions:
- Female HCM patients are diagnosed later, exhibit more advanced symptoms, and have higher rates of obstructive physiology.
- The female HCM phenotype includes diastolic dysfunction and elevated biomarkers, resembling heart failure with preserved ejection fraction.
- Addressing sex-specific disparities is essential for enhancing diagnostic awareness and personalizing therapeutic strategies in HCM.
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