Gender-specific differences in left ventricular remodelling and fibrosis in hypertrophic cardiomyopathy: insights from cardiovascular magnetic resonance.
BACKGROUND
Gender is an independent risk factor for heart failure mortality in hypertrophic cardiomyopathy (HCM).


OBJECTIVE
To explore the interaction between gender, myocardial fibrosis and remodelling in HCM.


METHODS
We studied 64 HCM patients (28 females, aged 51+/-16 years) categorized as non-obstructive (HNCM, n=31) or obstructive (HOCM, n=33) and 60 healthy subjects (31 females, aged 43+/-14 years). Cine imaging was performed to assess left ventricular volumes and mass. LV remodelling index (LVRI) was calculated. Extension of late gadolinium enhancement (LGE) was quantified.


RESULTS
Females in the control group and in the HNCM group had a lower LVRI than males (control: 0.7+/-0.1 vs. 0.9+/-0.2 g/ml, p<0.002; HNCM: 1.1+/-0.2 vs. 1.5+/-0.5 g/ml, p<0.001). In contrast, HOCM females had a similar LVRI compared to males (1.8+/-0.5 vs. 1.7+/-0.4 g/ml, p=ns). Thus the increase in LVRI was more pronounced in females compared to males. LGE was noted in 70% of the patients. No relation was found between the presence or the quantity of myocardial fibrosis and gender in any of the patient subgroups.


CONCLUSIONS
Our data suggest a disproportionate degree of remodelling in different forms of HCM depending on gender. Gender does not appear to influence the quantity of fibrosis as defined by LGE.
Schulz-Menger
Jeanette
J
Franz-Volhard-Klinik, Kardiologie, Charité Campus Buch, HELIOS-Klinikum Berlin, Universitätsmedizin Berlin, Germany. jeanette.schulz-menger@charite.de
Abdel-Aty
Hassan
H
Rudolph
Andre
A
Elgeti
Thomas
T
Messroghli
Daniel
D
Utz
Wolfgang
W
Boyé
Philipp
P
Bohl
Steffen
S
Busjahn
Andreas
A
Hamm
Bernd
B
Dietz
Rainer
R
D000704:Analysis of Variance; D002312:Cardiomyopathy, Hypertrophic / Q000503:physiopathology*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003287:Contrast Media; D005260:Female; D005355:Fibrosis / Q000503:physiopathology; D019786:Gadolinium DTPA; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D020257:Ventricular Remodeling / Q000502:physiology*
D003287:Contrast Media; D019786:Gadolinium DTPA