Impact of sex on timing and clinical outcome of septal myectomy for obstructive hypertrophic cardiomyopathy

被引:11
作者
Huurman, Roy [1 ]
Schinkel, Arend F. L. [1 ]
de Jong, Peter L. [2 ]
van Slegtenhorst, Marjon A. [3 ]
Hirsch, Alexander [1 ,4 ]
Michels, Michelle [1 ]
机构
[1] Univ Med Ctr Rotterdam, Erasmus MC, Dept Cardiol, NL-3015 GD Rotterdam, Netherlands
[2] Univ Med Ctr Rotterdam, Erasmus MC, Thoraxctr, Dept Cardiothorac Surg, NL-3015 GD Rotterdam, Netherlands
[3] Univ Med Ctr Rotterdam, Erasmus MC, Dept Clin Genet, NL-3015 GD Rotterdam, Netherlands
[4] Univ Med Ctr Rotterdam, Erasmus MC, Dept Radiol & Nucl Med, NL-3015 GD Rotterdam, Netherlands
关键词
Hypertrophic cardiomyopathy; Septal myectomy; Sex differences; Survival analysis; OUTFLOW TRACT OBSTRUCTION; CHAMBER QUANTIFICATION; EUROPEAN ASSOCIATION; AMERICAN SOCIETY; TASK-FORCE; BODY-SIZE; ECHOCARDIOGRAPHY; RECOMMENDATIONS; EXTENSION; DIAGNOSIS;
D O I
10.1016/j.ijcard.2020.08.059
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Sex disparities are common in hypertrophic cardiomyopathy (HCM). Previous research has shown that at time of myectomy, women are older, have greater impairment of diastolic function and more advanced cardiac remodeling. The clinical impact of these differences is unknown. Method: This study included 162 HCM patients (61% men) who underwent septal myectomy. Time to treatment was calculated in relation to symptom onset and diagnosis. Preand post-operative echocardiographic data were collected. Sex differences were assessed at baseline and in time-to-event survival analyses for the composite endpoint of all-cause mortality, cardiac transplantation, re-intervention and aborted sudden cardiac death. Results: Women were generally older at time of myectomy (57 vs. 49 years, p < 0.01), with similar time to treatment as measured from symptom onset (2.3 [1.3-6.0] vs. 2.8 [1.1-5.3] years, p > 0.05), but a shorter time since diagnosis compared to men (2.6 [1.2-7.0] vs. 4.3 [2.4-8.3] years, p = 0.02). Mean wall thickness and left atrial diameter were the same for men and women, but were higher in women when correcting for body surface area (absolute: 20 vs. 19 mm, 48 vs 46 mm, p = 0.05; corrected: 9.7 vs. 11.2 mm/m(2), 23.4 vs. 26.3 mm/m(2), p < 0.01). After 5.9 [3.0-9.1] years, 15% ofmen and 8% of women had reached the composite endpoint (p > 0.05). Conclusion: In conclusion, although women present later in life and seem to have more advanced disease on echocardiography, time until myectomy was similar and clinical outcomes after myectomy are favourable for both men and women. (C) 2020 The Author(s). Published by Elsevier B.V.
引用
收藏
页码:133 / 139
页数:7
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