title: Comparison of clinical findings in idiopathic dilated cardiomyopathy in women versus men. The Italian Multicenter Cardiomyopathy Study Group (SPIC)
abstract: Clinical and laboratory findings were compared in 65 women and 238 men with invasively documented idiopathic dilated cardiomyopathy. Women had more severe symptoms (New York Heart Association class > or = III in 48 vs 39%; p < 0.05), presented more frequently with heart failure signs (63 vs 41%; p < 0.01), and had a higher cardiothoracic ratio (0.56 +/- 0.06 vs 0.53 +/- 0.06; p < 0.05) and higher frequency of left bundle branch block (41 vs 29%; p < 0.05). Echocardiographic measurements in women showed significantly greater left ventricular (LV) end-diastolic (42 +/- 7 vs 39 +/- 6 mm/m2; p < 0.0001) and end-systolic (36 +/- 7 vs 33 +/- 6 mm/m2; p < 0.001) diameters, and mean myocardial thickness (11 +/- 2 vs 10 +/- 2 mm; p < 0.05). Exercise duration was shorter in women than in men (7 +/- 3 vs 10 +/- 4 minutes; p < 0.001). After 18 +/- 16 months, 9 women and 27 men died, and 7 and 17, respectively, received transplants. Transplant-free survival was not significantly different according to gender. By Cox multivariate analysis, LV ejection fraction was a significant independent predictor of cardiac death or heart transplantation in both sexes (p < 0.05 in men, and p < 0.005 in women), together with left atrial diameter index (p < 0.01) in women, and mean pulmonary artery pressure (p < 0.001) in men. In conclusion, women with idiopathic dilated cardiomyopathy present a more advanced phase of the disease with greater LV dilation, but do not have a different prognosis.
authors.affiliation: Dipartimento di Cardiologia A. De Gasperis, Ospedale Niguarda Ca' Granda, Milano, Italy.
authors.forename: R
authors.initials: R
authors.lastname: De Maria
authors.forename: A
authors.initials: A
authors.lastname: Gavazzi
authors.forename: F
authors.initials: F
authors.lastname: Recalcati
authors.forename: G
authors.initials: G
authors.lastname: Baroldi
authors.forename: C
authors.initials: C
authors.lastname: De Vita
authors.forename: F
authors.initials: F
authors.lastname: Camerini
mesh_terms: D000328:Adult; D000367:Age Factors; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis* / Q000401:mortality; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D012727:Sex Characteristics; D012737:Sex Factors; D016019:Survival Analysis