Clinical and demographic characteristics, prevalence of cardiometabolic risk factors, and peculiarities of the clinical course of hypertrophic cardiomyopathy in different age groups. Part two

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Clinical and demographic characteristics, prevalence of cardiometabolic risk factors (CMRF), and peculiarities of the clinical course of hypertrophic cardiomyopathy (HCM) in different age groups have been insufficiently studied.

The aim: to study the clinical and demographic characteristics, incidence of arterial hypertension (AH), obesity, and type 2 diabetes mellitus (T2DM) in patients with HCM, depending on hereditary factors, and clinical course of HCM in different age groups.

Material and methods. The study included 205 patients with HCM aged 18 to 87 years (58 [42; 65] years). 66 participants were diagnosed with familial HCM, and 139 with nonfamilial HCM. 55 patients were < 45 years old, and 150 were ≥ 45 years old. Patients aged ≥ 45 years were divided into groups: Group 1 – HCM without CMRF; Group 2 – HCM + arterial hypertension; Group 3 – HCM + arterial hypertension + obesity; Group 4 – HCM + arterial hypertension + obesity + T2DM.

Results. The ratio of male to female patients with HCM in patients aged <60 years was 1.6:1, and in those aged ≥60 years, it was 1:1.6 (p = 0.001). The prevalence of arterial hypertension, obesity, and T2DM in patients with nonfamilial HCM was 81.3, 46.8, and 20.1%, respectively, and was higher than in patients with familial HCM, where the similar rates were 31.8, 15.2, and 1.5%, respectively (p <0.001). In patients with HCM aged ≥ 45 years without CMRF (Group 1), the median age at diagnosis was 52.5 [47; 60.8] years, with HCM + AH (Group 2) – 62 [54; 67] years, with HCM + AH + obesity (Group 3) – 63 [56; 68] years, with HCM + AH + obesity + T2DM (Group 4) – 62 [60; 68] years (p1, 2 = 0.01, p1, 3 = 0.007 and p1, 4 = 0.008). Moreover, this index was higher in females than in males (63 [59; 69] versus 59 [51; 65] years, p = 0.01). In patients with HCM aged ≥45 years, Groups 1 and 2 showed a higher incidence of left ventricular asymmetry index (LVAI) ≥1.5, while Groups 3 and 4 were more likely to have LVAI <1.5 (p = 0.007).

Conclusion. HCM is a disease of young and middle-aged male individuals and elderly and senile females. The incidence of arterial hypertension, obesity, and T2DM was higher in non-familial HCM than in familial HCM. The presence and number of CMRF led to the masking of the underlying disease manifestations and the diagnosis of HCM at a later age. In females, the diagnosis was made later than in male patients. As the number of CMRF increased, an increase in left ventricular posterior wall thickness, a decrease in LVAI, and an increase in the number of symmetrical types of LV hypertrophy were observed.

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Tinatin Bezhanishvili

Pavlov University

Email: tinatin93@rambler.ru
ORCID iD: 0000-0002-3167-6340

MD, assistant at the Department of faculty therapy with a course in endocrinology, cardiology with the clinic named after academician G.F. Lang, junior researcher at the Department of cardiomyopathies, Research Institute of Cardiovascular Diseases of Scientific and Clinical Research Center

俄罗斯联邦, Saint Petersburg

Alexandra Gudkova

Pavlov University; Almazov National Medical Research Centre

编辑信件的主要联系方式.
Email: alexagood-1954@mail.ru
ORCID iD: 0000-0003-0156-8821
SPIN 代码: 7246-7349

MD, Dr. Sci. (Medicine), professor of the Department of faculty therapy with a course in endocrinology, cardiology with the clinic named after academician G.F. Lang, head of the Department of cardiomyopathies of the Research Institute of Cardiovascular Diseases of Scientific and Clinical Research Center, leading researcher at the Institute of Molecular Biology and Genetics

俄罗斯联邦, Saint Petersburg; Saint Petersburg

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2. 1. The incidence of hypertension, obesity, and type 2 diabetes mellitus in the studied patients with hypertrophic cardiomyopathy, regardless of the hereditary factor, as the age increases with an interval of 10 years.

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3. 2. Characteristics of the types of left ventricular hypertrophy with different left ventricular asymmetry index in the studied patients with hypertrophic cardiomyopathy aged > 45 years, depending on the number of cardiometabolic risk factors

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