• Tony Yw Li, Selvie Yeo, Nicholas Jh Ngiam, Chi-Hang Lee, Ting Ting Low, Yoke-Ching Lim, Lauren Kay Mance Evangelista, Edward Cy Lee, Novi Yanti Sari, Tiong-Cheng Yeo, James Wl Yip, Kian-Keong Poh, William Kf Kong, Weiqin Lin, Ching-Hui Sia, and Raymond Cc Wong.
• Department of Cardiology, National University Heart Centre, Singapore.
• Ann Acad Med Singap. 2023 Jul 28; 52 (7): 348355348-355.

IntroductionDespite the growing recognition that sex can affect the presentation and outcomes in hypertrophic cardiomyopathy (HCM), this relationship is understudied in Asians. Therefore, we aimed to explore sex differences in Asian patients with HCM.MethodA total of 295 consecutive patients diagnosed with HCM were recruited from a tertiary cardiology centre from 2010 to 2017 over a mean of 3.9±2.7 years. We evaluated the effects of sex on the outcomes of HCM in Asian patients.ResultsHCM patients were more commonly men (72%). Women were older and had more comorbidities, including hypertension and atrial fibrillation. On transthoracic echocardiography, the indexed left ventricular end-systolic and end-diastolic volumes were similar, but more women had more-than-moderate mitral regurgitation and had a smaller left ventricular outflow tract (LVOT). Women more commonly had findings of obstructive physiology with significant LVOT obstruction, defined as >30 mmHg at rest. The use of implantable cardioverter defibrillators was similar across sexes. On multivariable analysis, women were found to be more likely to develop progressive heart failure requiring admission (hazard ratio [HR] 2.10, 95% confidence interval [CI] 1.05-4.71, P=0.021) but had a lower rate of all-cause mortality (HR 0.36, 95% CI 0.19-0.70, P=0.003).ConclusionWomen diagnosed with HCM were older, had more comorbidities and were more likely to develop heart failure while men had a higher risk of all-cause mortality.

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