Abstract 17165: Gender-Specific Differences on Left Ventricular Diastolic Function in Patients with Apical Hypertrophic Cardiomyopathy
Background: Apical hypertrophic cardiomyopathy (HCM) is a variant of HCM and has a broad spectrum of clinical features. Left ventricular diastolic dysfunction is the most important factors to determine clinical feature of apical HCM. It has been reported that women are more susceptible to the left ventricular (LV) diastolic dysfunction than men. Although gender may be one of the important modifying factors in apical HCM, there has been little information on gender differences of LV diastolic function in patients with apical HCM.
Methods: From 2003 to 2009, a total of 454 patients (mean age : 60.9±11.2) who were diagnosed with apical HCM at Severance Cardiovascular Hospital were consecutively enrolled in this retrospective study. Clinical features and 2 dimensional echo-Doppler findings were analyzed between male and females.
Results: Female patients showed significantly higher age (66.5±9.7 vs 58.5±10.9, p < 0.001), higher left atrial (LA) volume index (32.7±1.09 vs 29.9±0.76, p=0.04), lower late diastolic mitral annular (Am) velocity (7.2±0.2 vs 7.97±0.14, p=0.002), lower systolic mitral annular (Sm) velocity (6.02±0.15 vs 6.57±0.11, p=0.004), and higher E/Em ratio (15.3±0.55 vs 13.8±0.38, p=0.031). There was no significant difference on LV ejection fraction. Female patients had a higher proportion of E/Em > 15 (47.1% versus 28.8%, p < 0.001) and higher proportion of E/A < 1 (56.5% versus 68.1%, p=0.031) adjusted to age.
Conclusion: The female patients with apical HCM had more advanced LV diastolic dysfunction with higher proportion of E/A <1, E/Em>15 and LA volume index compare with age adjusted male patients. This finding may suggest the potential reason for higher rate of symptoms and poor outcome in women with apical HCMP.
- © 2012 by American Heart Association, Inc.