Female sex is associated with worse prognosis in patients with hypertrophic cardiomyopathy in China

Yilu Wang; Jizheng Wang; Yubao Zou; Jingru Bao; Kai Sun; Ling Zhu; Tao Tian; Hu Shen; Xianliang Zhou; Ferhaan Ahmad; Rutai Hui; Lei Song

doi:10.1371/journal.pone.0102969

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Female sex is associated with worse prognosis in patients with hypertrophic cardiomyopathy in China

Journal article

Open access

Peer reviewed

Female sex is associated with worse prognosis in patients with hypertrophic cardiomyopathy in China

Yilu Wang, Jizheng Wang, Yubao Zou, Jingru Bao, Kai Sun, Ling Zhu, Tao Tian, Hu Shen, Xianliang Zhou, Ferhaan Ahmad, …

PloS one, Vol.9(7), pp.e102969-e102969

2014

DOI: 10.1371/journal.pone.0102969

PMCID: PMC4105411

PMID: 25047602

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Abstract

Sex plays an important role in the clinical expression and prognosis of various cardiovascular diseases. This study was designed to observe the effects of sex on hypertrophic cardiomyopathy (HCM). A total of 621 unrelated patients with HCM without heart failure (460 males) were enrolled from 1999 to 2011. Compared to male patients, at baseline female patients were older at diagnosis (49.6±17.2 years vs. 46.7±14.4 years, P = 0.033), and had greater frequency of left ventricular outflow tract obstruction (72/161, 44.7% vs. 149/460, 32.4%, P = 0.005). During the average four year follow-up period (range 2-7 years), survival analysis showed that the incidences of mortality from all causes, cardiovascular death and progression to chronic heart failure were greater in women than in men (P = 0.031, 0.040 and 0.012, respectively). After adjustment for multiple factors that may confound survival and cardiac function, female sex remained an independent risk factor for all-cause mortality, cardiovascular death, and chronic heart failure [hazard ratio (HR) 2.19, 95% confidence interval (CI) 1.21-3.95, P = 0.010; HR 2.19, 95% CI 1.17-4.09, P = 0.014; HR 1.73, 95% CI 1.12-2.69, P = 0.014, respectively] in HCM patients. Subgroup analysis revealed that female sex as a risk factor was identified only in patients younger than 50 years old (P = 0.011, 0.011 and 0.009, respectively), but not for those 50 years or older. Our results suggest that female sex is associated with worse survival and heart failure in HCM patients. Further studies are required to determine whether female hormones modify the clinical expression and prognosis of HCM.

Prognosis

Follow-Up Studies

Humans

Middle Aged

Risk Factors

Male

Ventricular Dysfunction, Left - diagnosis

Ventricular Dysfunction, Left - mortality

China - epidemiology

Cardiomyopathy, Hypertrophic - diagnosis

Ventricular Dysfunction, Left - physiopathology

Cardiomyopathy, Hypertrophic - mortality

Cardiomyopathy, Hypertrophic - physiopathology

Age of Onset

Sex Factors

Survival Analysis

Aged, 80 and over

Adult

Female

Aged

Details

Title: Subtitle: Female sex is associated with worse prognosis in patients with hypertrophic cardiomyopathy in China
Creators: Yilu Wang - Department of ICU, China Meitan General Hospital, Beijing, China
Jizheng Wang - Sino-German Laboratory for Molecular Medicine, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Yubao Zou - Department of Cardiovascular Internal Medicine, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Jingru Bao - Center for cardiovascular diseases, PLA Navy General Hospital, Beijing, China
Kai Sun - Sino-German Laboratory for Molecular Medicine, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Ling Zhu - Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, Shanxi Province, China
Tao Tian - Department of Cardiovascular Internal Medicine, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Hu Shen - Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, Shanxi Province, China
Xianliang Zhou - Hypertension Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Ferhaan Ahmad - Division of Cardiovascular Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, United States of America
Rutai Hui - Sino-German Laboratory for Molecular Medicine, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Cardiovascular Internal Medicine, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Hypertension Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Lei Song - Sino-German Laboratory for Molecular Medicine, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Cardiovascular Internal Medicine, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Hypertension Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Resource Type: Journal article
Publication Details: PloS one, Vol.9(7), pp.e102969-e102969
DOI: 10.1371/journal.pone.0102969
PMID: 25047602
PMCID: PMC4105411
NLM abbreviation: PLoS One
ISSN: 1932-6203
eISSN: 1932-6203
Publisher: Public Library of Science; United States
Language: English
Date published: 2014
Academic Unit: Radiology; Molecular Physiology and Biophysics; Cardiovascular Medicine; Fraternal Order of Eagles Diabetes Research Center; Internal Medicine
Record Identifier: 9984025472102771

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