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Sex differences in hypertrophic cardiomyopathy

new insights

van Driel, Beaua; Nijenkamp, Louisea; Huurman, Royb; Michels, Michelleb; van der Velden, Jolandaa

Current Opinion in Cardiology: May 2019 - Volume 34 - Issue 3 - p 254–259
doi: 10.1097/HCO.0000000000000612
MOLECULAR GENETICS: Edited by Ali J. Marian

Purpose of review 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.

Recent findings 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.

Summary 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.

aDepartment of Physiology, Amsterdam University Medical Center, Location VUmc, Amsterdam

bDepartment of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands

Correspondence to Beau van Driel, Department of Physiology, Amsterdam University Medical Center, Location VUmc De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands. Tel: +31 20 44 43 185; e-mail:

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