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Gender-Related Differences in the Clinical Presentation and Outcome of Hypertrophic Cardiomyopathy

Iacopo Olivotto, MD^_*,_*, Martin S. Maron, MD, A. Selcuk Adabag, MD, Susan A. Casey, RN, Daniela Vargiu, RN^_*, Mark S. Link, MD, James E. Udelson, MD, Franco Cecchi, MD^_* and Barry J. Maron, MD, FACC

^_* Regional Referral Center for Myocardial Diseases, Azienda Ospedaliera Universitaria Careggi, Florence, Italy
The Hypertrophic Cardiomyopathy Center, Minneapolis Heart Institute Foundation, Minneapolis, Minnesota
Hypertrophic Cardiomyopathy Center, Division of Cardiology, Tufts-New England Medical Center, Boston, Massachusetts.

View larger version (27K): [in a new window]   Figure 1 Distribution of 969 male and female patients with hypertrophic cardiomyopathy according to year of initial evaluation (top panel) and age at initial evaluation (bottom panel).

View larger version (14K): [in a new window]   Figure 2 Relation of gender to overall hypertrophic cardiomyopathy (HCM)-related mortality (left panel) and progression to New York Heart Association (NYHA) functional classes III and IV, or heart failure (HF) or stroke death (right panel). Hazard plot based on multivariate Cox regression analysis including age, NYHA functional class, and left ventricular outflow obstruction (gradient 30 mm Hg at rest) at initial evaluation. *Patients who were already in NYHA functional classes III to IV at first evaluation were excluded from this analysis.

View larger version (16K): [in a new window]   Figure 3 Cumulative risk of progression to New York Heart Association (NYHA) functional classes III and IV, or heart failure (HF) or stroke death related to age at initial evaluation and gender. Patients who were already in NYHA functional classes III to IV at initial evaluation were excluded from this analysis. Female patients >50 years versus female patients 50 years of age (p < 0.005); male patients >50 years versus male patients 50 years of age (p = 0.02).