Sex-Related Differences in Patients With Hypertrophic Cardiomyopathy Undergoing Alcohol Septal Ablation.
J Am Heart Assoc
; 13(9): e032553, 2024 May 07.
Article
de En
| MEDLINE
| ID: mdl-38700034
ABSTRACT
BACKGROUND:
Previous studies have shown that women with hypertrophic obstructive cardiomyopathy (HCM) have worse long-term outcomes irrespective of intervention. However, the outcomes of patients undergoing alcohol septal ablation (ASA) based on sex have not been described. Hence, this study aimed to evaluate pressure changes and long-term mortality in patients with HCM undergoing ASA based on sex. METHODS ANDRESULTS:
This is a single-center retrospective study evaluating hemodynamic changes and long-term mortality in patients with HCM treated with ASA according to sex. A total of 259 patients were included (aged 68.4±11.9 years, 62.2% women). Women had higher age and baseline pressures at the time of ASA, with a greater percent reduction in mean left atrial pressure (men versus women 2.2% versus 15.9%, respectively; P=0.02). Women had better survival (median survival rate of men versus women 8.6 versus 12.5 years, respectively; P=0.011). On Cox multivariable regression, predictors of mortality were age (per group change <60 years, 61-70 years, 71-80 years, and >80 years; hazard ratio [HR], 1.45 [95% CI, 1.10-1.91], P=0.008), female sex (HR, 0.59 [95% CI, 0.35-0.99], P=0.048), chronic kidney disease (HR, 1.88 [95% CI, 1.06-3.33], P=0.031), and left ventricular outflow tract gradient reduction ≤86% (HR, 1.91 [95% CI, 1.14-3.19], P=0.014).CONCLUSIONS:
Women with HCM undergoing ASA are older and have higher left-sided baseline pressures compared with men yet have better survival. Further studies exploring the mechanisms of differential outcomes according to sex in patients with HCM undergoing ASA are needed.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Cardiomyopathie hypertrophique
/
Éthanol
/
Techniques d'ablation
Limites:
Aged
/
Aged80
/
Female
/
Humans
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Male
/
Middle aged
Langue:
En
Journal:
J Am Heart Assoc
/
Journal of the American Heart Association
/
Journal of the American Heart Association. Cardiovascular and cerebrovascular disease
Année:
2024
Type de document:
Article
Pays de publication:
Royaume-Uni