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Sex-based differences in the phenotypic expression and prognosis of idiopathic non-ischaemic cardiomyopathy: a cardiovascular magnetic resonance study.
- Source :
- European Heart Journal - Cardiovascular Imaging; Jun2024, Vol. 25 Issue 6, p804-813, 10p
- Publication Year :
- 2024
-
Abstract
- Aims We sought to characterize sex-related differences in cardiovascular magnetic resonance-based cardiovascular phenotypes and prognosis in patients with idiopathic non-ischaemic cardiomyopathy (NICM). Methods and results Patients with NICM enrolled in the Cardiovascular Imaging Registry of Calgary (CIROC) between 2015 and 2021 were identified. Z -score values for chamber volumes and function were calculated as standard deviation from mean values of 157 sex-matched healthy volunteers, ensuring reported differences were independent of known sex-dependencies. Patients were followed for the composite outcome of all-cause mortality, heart failure admission, or ventricular arrhythmia. A total of 747 patients were studied, 531 (71%) males. By Z -score values, females showed significantly higher left ventricular (LV) ejection fraction (EF; median difference 1 SD) and right ventricular (RV) EF (difference 0.6 SD) with greater LV mass (difference 2.1 SD; P < 0.01 for all) vs. males despite similar chamber volumes. Females had a significantly lower prevalence of mid-wall striae (MWS) fibrosis (22% vs. 34%; P < 0.001). Over a median follow-up of 4.7 years, 173 patients (23%) developed the composite outcome, with equal distribution in males and females. LV EF and MWS were significant independent predictors of the outcome (respective HR [95% CI] 0.97 [0.95–0.99] and 1.6 [1.2–2.3]; P = 0.003 and 0.005). There was no association of sex with the outcome. Conclusion In a large contemporary cohort, NICM was uniquely expressed in females vs. males. Despite similar chamber dilation, females demonstrated greater concentric remodelling, lower reductions in bi-ventricular function, and a lower burden of replacement fibrosis. Overall, their prognosis remained similar to male patients with NICM. [ABSTRACT FROM AUTHOR]
- Subjects :
- LEFT heart ventricle
CARDIOMYOPATHIES
RESEARCH funding
PATIENTS
VENTRICULAR ejection fraction
MYOCARDIAL ischemia
LEFT heart atrium
SEX distribution
HOSPITAL admission & discharge
DESCRIPTIVE statistics
CAUSES of death
HEART failure
FIBROSIS
CARDIOVASCULAR disease diagnosis
MAGNETIC resonance angiography
VENTRICULAR arrhythmia
RIGHT heart atrium
CORONARY angiography
RIGHT heart ventricle
CONFIDENCE intervals
STROKE volume (Cardiac output)
PHENOTYPES
Subjects
Details
- Language :
- English
- ISSN :
- 20472404
- Volume :
- 25
- Issue :
- 6
- Database :
- Complementary Index
- Journal :
- European Heart Journal - Cardiovascular Imaging
- Publication Type :
- Academic Journal
- Accession number :
- 177659496
- Full Text :
- https://doi.org/10.1093/ehjci/jeae014