Heart failure & cardiomyopathies
Sex-based differences in the phenotypic expression and prognosis of idiopathic non-ischaemic cardiomyopathy: a cardiovascular magnetic resonance study
Authors' 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.
Study context
- Population
- Patients with idiopathic non-ischaemic cardiomyopathy (NICM) in the Cardiovascular Imaging Registry of Calgary (CIROC), 2015–2021531 (71%) males
- Participants
- 747 patients
- Exposure
- Females vs males with idiopathic NICM
- Malesn = 531reference
- Outcome
- Sex-related differences in CMR phenotypes and prognosis (composite of all-cause mortality, HF admission or ventricular arrhythmia)
- Follow-up
- Median 4.7 years
Methodological detailsCMR-based, Z-scores vs 157 sex-matched healthy volunteers
- CMR-based
- Z-scores vs 157 sex-matched healthy volunteers
Main finding
As reported in the abstract
Median difference
1 SD
P < 0.01
LVEF, higher in females
Difference
0.6 SD
P < 0.01
RVEF, higher in females
Difference
2.1 SD
P < 0.01
Left ventricular (LV) mass, greater in females
Observational data: associations, not effects.
Further findings
Prevalence of mid-wall striae (MWS) fibrosis
Independent predictors of composite outcome · median follow-up 4.7 years
| HR (95% CI) | P value | ||
|---|---|---|---|
| LV EF | 0.97 (0.95–0.99) | P = 0.003 | |
| MWS | 1.6 (1.2–2.3) | P = 0.005 | |
| 0.512Hazard ratio (log scale) |
- Prevalence of mid-wall striae (MWS) fibrosis: P < 0.001
Z-score differences: LV ejection fraction (EF), right ventricular (RV) EF, LV mass (females vs males)
- Similar chamber volumes
Independent predictors of composite outcome · median follow-up 4.7 years
- No association of sex with the outcome
Original publication
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