Gender Related Differences in the Clinical Presentation of Hypertrophic Cardiomyopathy—An Analysis from the SILICOFCM Database
Andrej Preveden,
Miodrag Golubovic,
Marija Bjelobrk,
Tatjana Miljkovic,
Aleksandra Ilic,
Snezana Stojsic,
Dragan Gajic,
Mila Glavaski,
Lars S. Maier,
Nduka Okwose,
Dejana Popovic,
Fausto Barlocco,
Arsen Ristic,
Guy A. MacGowan,
Iacopo Olivotto,
Nenad Filipovic,
Djordje G. Jakovljevic,
Lazar Velicki
Affiliations
Andrej Preveden
Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
Miodrag Golubovic
Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
Marija Bjelobrk
Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
Tatjana Miljkovic
Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
Aleksandra Ilic
Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
Snezana Stojsic
Institute of Cardiovascular Diseases Vojvodina, 21204 Sremska Kamenica, Serbia
Dragan Gajic
Institute of Cardiovascular Diseases Vojvodina, 21204 Sremska Kamenica, Serbia
Mila Glavaski
Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
Lars S. Maier
Department of Internal Medicine II (Cardiology, Pneumology, and Intensive Care), University Medical Centre Regensburg, 93053 Regensburg, Germany
Nduka Okwose
Cardiovascular Research, Translational and Clinical Research and Biosciences Institute, Medicine, Newcastle University, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE2 4HH, UK
Dejana Popovic
Clinical Center of Serbia, 11000 Belgrade, Serbia
Fausto Barlocco
Department of Experimental and Clinical Medicine, University of Florence, 50121 Florence, Italy
Arsen Ristic
Clinical Center of Serbia, 11000 Belgrade, Serbia
Guy A. MacGowan
Cardiovascular Research, Translational and Clinical Research and Biosciences Institute, Medicine, Newcastle University, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE2 4HH, UK
Iacopo Olivotto
Department of Experimental and Clinical Medicine, University of Florence, 50121 Florence, Italy
Nenad Filipovic
Bioengineering Research and Development Center, BioIRC, 34000 Kragujevac, Serbia
Djordje G. Jakovljevic
Cardiovascular Research, Translational and Clinical Research and Biosciences Institute, Medicine, Newcastle University, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE2 4HH, UK
Lazar Velicki
Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
Background and Objectives: Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiac disease that affects approximately 1 in 500 people. Due to an incomplete disease penetrance associated with numerous factors, HCM is not manifested in all carriers of genetic mutation. Although about two-thirds of patients are male, it seems that female gender is associated with more severe disease phenotype and worse prognosis. The objective of this study was to evaluate the gender related differences in HCM presentation. Materials and Methods: This study was conducted as a part of the international multidisciplinary SILICOFCM project. Clinical information, laboratory analyses, electrocardiography, echocardiography, and genetic testing data were collected for 362 HCM patients from four clinical centers (Florence, Newcastle, Novi Sad, and Regensburg). There were 33% female patients, and 67% male patients. Results: Female patients were older than males (64.5 vs. 53.5 years, p p = 0.003), most frequently complaining of dyspnea (50% vs. 30%), followed by chest pain (30% vs. 17%), fatigue (26% vs. 13%), palpitations (22% vs. 13%), and syncope (13% vs. 8%). The most common rhythm disorder was atrial fibrillation which was present in a similar number of females and males (19% vs. 13%, p = 0.218). Levels of N-terminal pro-brain natriuretic peptide were comparable between the genders (571 vs. 794 ng/L, p = 0.244). Echocardiography showed similar thickness of interventricular septum (18 vs. 16 mm, p = 0.121) and posterolateral wall (13 vs. 12 mm, p = 0.656), however, females had a lower number of systolic anterior motion (8% vs. 16%, p = 0.020) and other mitral valve abnormalities. Conclusions: Female patients are underrepresented but seem to have a more pronounced clinical presentation of HCM. Therefore, establishing gender specific diagnostic criteria for HCM should be considered.
