Gender‐specific differences in left ventricular remodelling and fibrosis in hypertrophic cardiomyopathy: Insights from cardiovascular magnetic resonance

Abstract

1 Background: Gender is an independent risk factor for heart failure mortality in hypertrophic cardiomyopathy (HCM). 2 Aims: To explore the interaction between gender, myocardial fibrosis and remodelling in HCM. 3 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. 4 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, pp=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. 5 Conclusion: 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.