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Sex differences in cardiac magnetic resonance features in patients with hypertrophic cardiomyopathy

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Abstract

Whether sex differences exist in cardiac magnetic resonance (CMR) findings in patients with hypertrophic cardiomyopathy (HCM) remain unknown. We sought to assess and compare CMR characteristics in male and female patients with HCM. From January-2006 to October-2017, 165 consecutive HCM patients evaluated with CMR were included. All clinical and complementary test information was prospectively collected. At the time of CMR evaluation women were older (70 [57–75] vs. 61 [47–72] years, p = 0.02) and more symptomatic in terms of dyspnea (New York Heart Association class II–IV 47.2 vs. 24.1%, p = 0.003) and palpitations (19.6 vs. 4.6%, p = 0.006) and received more frequently treatment with diuretics (49.1% vs. 23.4%, p = 0.001). On echocardiographic examination more women had obstructive physiology (45.1 vs. 20.6%, p = 0.002). On CMR evaluation, women showed smaller left ventricular end-systolic volume index (13 [10–15] vs. 16 [13–21] ml/m2, p < 0.001), higher left ventricular ejection fraction (77 [74–80] vs. 72 [66–78]%, p = 0.004), more marked left ventricular outflow tract acceleration (54.7 vs. 26.4%, p < 0.001) and mitral regurgitation (33.3 vs. 12.7%, p = 0.002). In multivariable analysis, female sex [OR 2.44 (1.04–5.73), p = 0.04] and left ventricular end-systolic volume index [OR 1.60 (1.08–2.38), p = 0.018] were independently associated with obstructive physiology. Women with HCM have more frequently obstructive physiology, a finding that could be related to the smaller left ventricular end-systolic volume.

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Data availability

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

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Funding

This study received no funding.

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Authors and Affiliations

  1. Cardiology Department, Hospital Universitario de la Princesa, IIS-IP, Universidad Autónoma de Madrid, Calle Diego de León, 62, 28006, Madrid, Spain

    María Teresa Nogales-Romo, Alberto Cecconi, Luis Jesús Jiménez-Borreguero & Fernando Alfonso

  2. Radiology Department, Hospital Universitario de la Princesa, IIS-IP, Universidad Autónoma de Madrid, Calle Diego de León, 62, 28006, Madrid, Spain

    Maria José Olivera, Paloma Caballero & Susana Hernández

Authors
  1. María Teresa Nogales-Romo
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  2. Alberto Cecconi
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  3. Maria José Olivera
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  4. Paloma Caballero
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  5. Susana Hernández
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  6. Luis Jesús Jiménez-Borreguero
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  7. Fernando Alfonso
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Contributions

MTNR performed analysis and interpretation of CMR studies. Also collected, analyzed and interpreted the patient data and was a major contributor in writing the manuscript. MJO, PC, SH, AC and LJJB performed analysis and interpretation of CMR studies. AC, LJJB and FA interpreted patient data and were major contributors in writing the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Luis Jesús Jiménez-Borreguero.

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The protocol complied with the recommendations of the 1975 Declaration of Helsinki for investigation with human subjects and with the ethical standards of the institutional research committee.

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Informed consent was obtained from all participants included in the study.

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Nogales-Romo, M.T., Cecconi, A., Olivera, M.J. et al. Sex differences in cardiac magnetic resonance features in patients with hypertrophic cardiomyopathy. Int J Cardiovasc Imaging 36, 1751–1759 (2020). https://doi.org/10.1007/s10554-020-01880-y

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  • DOI: https://doi.org/10.1007/s10554-020-01880-y

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