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Sex Differences at the Time of Myectomy in Hypertrophic Cardiomyopathy.

Publication ,  Journal Article
Nijenkamp, LLAM; Bollen, IAE; van Velzen, HG; Regan, JA; van Slegtenhorst, M; Niessen, HWM; Schinkel, AFL; Krüger, M; Poggesi, C; Ho, CY ...
Published in: Circulation. Heart failure
June 2018

One of the first clinically detectable alterations in heart function in hypertrophic cardiomyopathy (HCM) is a decline in diastolic function. Diastolic dysfunction is caused by changes in intrinsic properties of cardiomyocytes or an increase in fibrosis. We investigated whether clinical and cellular parameters of diastolic function are different between male and female patients with HCM at the time of myectomy.Cardiac tissue from the interventricular septum of patients with HCM (27 women and 44 men) was obtained during myectomy preceded by echocardiography. At myectomy, female patients were 7 years older than male patients and showed more advanced diastolic dysfunction than men evident from significantly higher values for E/e' ratio, left ventricular filling pattern, tricuspid regurgitation velocity, and left atrial diameter indexed for body surface. Whereas most male patients (56%) showed mild (grade I) diastolic dysfunction, 50% of female patients showed grade III diastolic dysfunction. Passive tension in HCM cardiomyocytes was comparable with controls, and myofilament calcium sensitivity was higher in HCM compared with controls, but no sex differences were observed in myofilament function. In female patients with HCM, titin was more compliant, and more fibrosis was present compared with men. Differences between female and male patients with HCM remained significant after correction for age.Female patients with HCM are older at the time of myectomy and show greater impairment of diastolic function. Furthermore, left ventricular and left atrial remodeling is increased in women when corrected for body surface area. At a cellular level, HCM women showed increased compliant titin and a larger degree of interstitial fibrosis.

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Published In

Circulation. Heart failure

DOI

EISSN

1941-3297

ISSN

1941-3289

Publication Date

June 2018

Volume

11

Issue

6

Start / End Page

e004133

Related Subject Headings

  • Young Adult
  • Ventricular Dysfunction, Left
  • Sex Characteristics
  • Myocytes, Cardiac
  • Middle Aged
  • Male
  • Humans
  • Heart Ventricles
  • Heart Failure
  • Heart Atria
 

Citation

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Nijenkamp, L. L. A. M., Bollen, I. A. E., van Velzen, H. G., Regan, J. A., van Slegtenhorst, M., Niessen, H. W. M., … van der Velden, J. (2018). Sex Differences at the Time of Myectomy in Hypertrophic Cardiomyopathy. Circulation. Heart Failure, 11(6), e004133. https://doi.org/10.1161/circheartfailure.117.004133
Nijenkamp, Louise L. A. M., Ilse A. E. Bollen, Hannah G. van Velzen, Jessica A. Regan, Marjon van Slegtenhorst, Hans W. M. Niessen, Arend F. L. Schinkel, et al. “Sex Differences at the Time of Myectomy in Hypertrophic Cardiomyopathy.Circulation. Heart Failure 11, no. 6 (June 2018): e004133. https://doi.org/10.1161/circheartfailure.117.004133.
Nijenkamp LLAM, Bollen IAE, van Velzen HG, Regan JA, van Slegtenhorst M, Niessen HWM, et al. Sex Differences at the Time of Myectomy in Hypertrophic Cardiomyopathy. Circulation Heart failure. 2018 Jun;11(6):e004133.
Nijenkamp, Louise L. A. M., et al. “Sex Differences at the Time of Myectomy in Hypertrophic Cardiomyopathy.Circulation. Heart Failure, vol. 11, no. 6, June 2018, p. e004133. Epmc, doi:10.1161/circheartfailure.117.004133.
Nijenkamp LLAM, Bollen IAE, van Velzen HG, Regan JA, van Slegtenhorst M, Niessen HWM, Schinkel AFL, Krüger M, Poggesi C, Ho CY, Kuster DWD, Michels M, van der Velden J. Sex Differences at the Time of Myectomy in Hypertrophic Cardiomyopathy. Circulation Heart failure. 2018 Jun;11(6):e004133.

Published In

Circulation. Heart failure

DOI

EISSN

1941-3297

ISSN

1941-3289

Publication Date

June 2018

Volume

11

Issue

6

Start / End Page

e004133

Related Subject Headings

  • Young Adult
  • Ventricular Dysfunction, Left
  • Sex Characteristics
  • Myocytes, Cardiac
  • Middle Aged
  • Male
  • Humans
  • Heart Ventricles
  • Heart Failure
  • Heart Atria