Department of Physiology, Amsterdam University Medical Center, Location VUmc, Amsterdam.
Department of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands.
Curr Opin Cardiol. 2019 May;34(3):254-259. doi: 10.1097/HCO.0000000000000612.
Hypertrophic cardiomyopathy (HCM) is the most common genetic cardiomyopathy, diagnosed by left ventricular hypertrophy of at least 15 mm maximal wall thickness (MWT). Recent studies reported a sex difference in clinical presentation, progression and outcome of HCM. This review provides an overview of recent studies into sex differences in HCM.
A higher number of men (55-65% of total HCM patient group) with manifest HCM has been observed, whereas female patients are older at first evaluation and diagnosis, present more frequently with symptoms, and have worse survival. Additionally, women have relatively smaller hearts even when corrected for body surface area (BSA), but female HCM patients have a higher interventricular septum thickness after correction for BSA.
Female HCM patients are possibly in a more advanced stage of disease at time of diagnosis because they require relatively more hypertrophy to reach the diagnostic threshold of at least 15 mm MWT. Additional studies are warranted to explore sex-specific diagnostic criteria for HCM.
肥厚型心肌病（HCM）是最常见的遗传性心肌病，通过左心室肥厚至少 15mm 最大壁厚度（MWT）诊断。最近的研究报告称，HCM 的临床表现、进展和结局存在性别差异。这篇综述概述了 HCM 中性别差异的最新研究。
患有明显 HCM 的男性人数较多（占总 HCM 患者群体的 55-65%），而女性患者在首次评估和诊断时年龄更大，更常出现症状，且存活率更低。此外，即使校正了体表面积（BSA），女性的心脏也相对较小，但校正 BSA 后，女性 HCM 患者的室间隔厚度更高。
女性 HCM 患者在诊断时可能处于疾病的更晚期，因为她们需要相对更多的肥大才能达到至少 15mm MWT 的诊断阈值。需要进一步研究以探索 HCM 的特定性别诊断标准。
