Related Experiment Video

Updated: Jun 24, 2026

Investigating the Pathogenesis of MYH7 Mutation Gly823Glu in Familial Hypertrophic Cardiomyopathy using a Mouse Model
03:45

Investigating the Pathogenesis of MYH7 Mutation Gly823Glu in Familial Hypertrophic Cardiomyopathy using a Mouse Model

Published on: August 8, 2022

Sex Differences in Characteristics and Outcomes Among Patients With Hypertrophic Cardiomyopathy: Insights From the

Masayuki Nakamura1, Haruhiko Abe1, Yasunori Ueda1

  • 1Cardiovascular Division NHO Osaka National Hospital Osaka Japan.

Journal of the American Heart Association
|June 23, 2026
PubMed

Insights

Women with hypertrophic cardiomyopathy (HCM) face higher cardiovascular death risks, often due to older age, more severe symptoms, and increased wall thickness. These factors largely explain the observed sex disparity in HCM outcomes.

Area of Science:

  • Cardiology
  • Genetics
  • Internal Medicine

Background:

  • Female sex is linked to poorer prognosis in hypertrophic cardiomyopathy (HCM).
  • Factors driving this sex disparity in HCM outcomes are not fully understood.
  • This study investigates sex differences in HCM clinical characteristics and cardiovascular death risk in Japan.

Purpose of the Study:

  • To clarify sex differences in clinical presentation and outcomes for hypertrophic cardiomyopathy (HCM) patients.
  • To identify factors associated with cardiovascular death in a Japanese HCM cohort.
  • To determine if sex differences in risk factors explain the observed outcome disparities.

Main Methods:

  • A multicenter, retrospective observational study (REVEAL-HCM) of 3247 HCM patients (≥16 years) in Japan (2006-2018).
  • Assessment of baseline characteristics and clinical outcomes, including cardiovascular death.
  • Univariable and multivariable Cox proportional hazards models were used to identify predictors of cardiovascular death.

Main Results:

  • Women were older and presented with more severe symptoms (NYHA class II-IV) than men (52% vs 35%).
  • Cardiovascular death was more frequent in women (HR 1.37; P=0.03).
  • Independent predictors of cardiovascular death included older age, advanced NYHA class, atrial fibrillation, greater maximal wall thickness, and apical HCM, which attenuated the HR for female sex.

Conclusions:

  • Significant sex differences in clinical characteristics and outcomes were observed in Japanese HCM patients.
  • The higher cardiovascular death rate in women was primarily explained by older age, more advanced symptoms, and greater indexed wall thickness.
  • Sex-specific differences in the prevalence and prognostic impact of apical HCM also contributed to the observed outcome disparities.
Abstract

Keywords:
hypertrophic cardiomyopathyoutcomessex difference

More Related Videos

An Approach to Study Shape-Dependent Transcriptomics at a Single Cell Level06:02

An Approach to Study Shape-Dependent Transcriptomics at a Single Cell Level

Published on: November 2, 2020

Isolation and Functional Characterization of Human Ventricular Cardiomyocytes from Fresh Surgical Samples14:39

Isolation and Functional Characterization of Human Ventricular Cardiomyocytes from Fresh Surgical Samples

Published on: April 21, 2014

Related Concept Videos

Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
Cardiomyopathy IV: Restrictive Cardiomyopathy01:29

Cardiomyopathy IV: Restrictive Cardiomyopathy

Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...
Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
Cardiomyopathy I: Introduction and Classification01:25

Cardiomyopathy I: Introduction and Classification

Cardiomyopathy, or CMP, is a group of diseases affecting the myocardial structure, impairing its ability to pump blood effectively. This condition can lead to arrhythmias, heart failure, or sudden cardiac death.Cardiomyopathies are classified into primary and secondary categories:Primary Cardiomyopathy refers to conditions involving only the heart muscle that are often idiopathic (of unknown cause) or genetic. They primarily affect the myocardium without the involvement of other systemic...
Hypertension III: Clinical Manifestations and Diagnostic Studies01:30

Hypertension III: Clinical Manifestations and Diagnostic Studies

Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...