Heart failure & cardiomyopathiesMeta-analysis
Systematic Review, Meta-Analysis, and Population Study to Determine the Biologic Sex Ratio in Dilated Cardiomyopathy
- Systematic review and meta-analysis with population study
- metaregression
- UK Biobank imaging cohort
Authors' conclusion
This study demonstrates that DCM is twice as prevalent in male patients. This was partially mitigated by implementing sex-specific DCM diagnostic criteria. The persistent male excess in genotype-positive patients with an equally prevalent genetic risk suggests additional genetic or environmental drivers for sex-biased penetrance.
Study context
- Population
- Adult dilated cardiomyopathy (DCM) patient cohorts (n≥100; excluding pediatric and peripartum)
- Participants
- 37,525 participants · 99 studies
- Comparison
- Female proportion in DCM overall vs genetic subtypes
- Outcome
- Proportion of female participants (sex ratio) in DCM, by genetic status
Pooled result
As reported in the abstract
Female proportion
| Group | Value | M:F | P vs overall |
|---|---|---|---|
| Overall DCM | 0.30 (95% CI 0.28–0.32) | 2.38:1 | |
| Identified DCM variant | 0.31 (95% CI 0.26–0.36) | 2.22:1 | P=0.56 |
| Gene-elusive DCM | 0.30 (95% CI 0.24–0.37) | 2.29:1 | P=0.81 |
| TTN | 0.28 (95% CI 0.22–0.36) | 2.51:1 | P=0.82 |
| LMNA | 0.35 (95% CI 0.27–0.44) | 1.84:1 | P=0.41 |
| Autosomal dominant gene variants | 0.34 (95% CI 0.28–0.40) | 1.98:1 | P=0.19 |
Further pooled results
Population DCM M:F ratio by diagnostic approach (UK Biobank, n=47 549)
- ICD-10 coding
- 4.5:1
- Sex-specific imaging-first
- 1.7:1
- Genotype-first
- 2.3:1
Original publication
Systematic Review, Meta-Analysis, and Population Study to Determine the Biologic Sex Ratio in Dilated Cardiomyopathy. Circulation. Published 3 February 2025. doi:10.1161/circulationaha.124.070872
Summarised from the published abstract; every number is checked against it