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European Journal of Heart Failure 2008 10(9):850-854; doi:10.1016/j.ejheart.2008.06.021
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© 2008 European Society of Cardiology

Gender-specific differences in left ventricular remodelling and fibrosis in hypertrophic cardiomyopathy: Insights from cardiovascular magnetic resonance

Jeanette Schulz-Mengera,*,1, Hassan Abdel-Atya,1, Andre Rudolpha, Thomas Elgetib, Daniel Messroghlib, Wolfgang Utza, Philipp Boyéa, Steffen Bohla, Andreas Busjahnc, Bernd Hammb and Rainer Dietza

a Franz-Volhard-Klinik, Kardiologie, Charité Campus Buch, HELIOS-Klinikum Berlin, Universitätsmedizin Berlin Germany
b Institut für Radiologie, Charite Campus Mitte, Universitätsmedizin Berlin Germany
c HealthTwiSt GmbH Berlin, Germany

* Corresponding author. Schwanebecker Chaussee 50 D-13125 Berlin, Germany. Tel.: +49 30 940152903; fax: +49 30 940152919. E-mail address: jeanette.schulz-menger{at}charite.de (J. Schulz-Menger).


  Abstract

Background: Gender is an independent risk factor for heart failure mortality in hypertrophic cardiomyopathy (HCM).

Aims: To explore the interaction between gender, myocardial fibrosis and remodelling in HCM.

Methods: We studied 64 HCM patients (28 females, aged 51 ± 16 years) categorized as non-obstructive (HNCM, n=31) or obstructive (HOCM, n=33) and 60 healthy subjects (31 females, aged 43 ± 14 years). Cine imaging was performed to assess left ventricular volumes and mass. LV remodelling index (LVRI) was calculated. Extension of late gadolinium enhancement (LGE) was quantified.

Results: Females in the control group and in the HNCM group had a lower LVRI than males (control: 0.7±0.1 vs. 0.9±0.2 g/ml, <0.002; HNCM: 1.1±0.2 vs. 1.5±0.5 g/ml, p<0.001). In contrast, HOCM females had a similar LVRI compared to males (1.8±0.5 vs. 1.7±0.4 g/ml, p=ns). Thus the increase in LVRI was more pronounced in females compared to males. LGE was noted in 70% of the patients. No relation was found between the presence or the quantity of myocardial fibrosis and gender in any of the patient subgroups.

Conclusion: Our data suggest a disproportionate degree of remodelling in different forms of HCM depending on gender. Gender does not appear to influence the quantity of fibrosis as defined by LGE.

Key Words: Hypertrophic cardiomyopathy • Gender • Cardiovascular magnetic resonance • Late gadolinium enhancement

Received November 16, 2007; Revised April 23, 2008; Accepted June 9, 2008

1 Both authors contributed equally to the manuscript.


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