Reshma Golamari, Alexander Khodak, Steven D Hartman, Marissa Donatelle, Tarec K Elajami, Rafle Fernandez, Christos G Mihos
{"title":"西班牙-拉丁裔与肥厚性心肌病患者更严重的心衰症状相关","authors":"Reshma Golamari, Alexander Khodak, Steven D Hartman, Marissa Donatelle, Tarec K Elajami, Rafle Fernandez, Christos G Mihos","doi":"10.31083/RCM26588","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Data regarding racial differences in patients with hypertrophic cardiomyopathy (HCM) is sparse. We hypothesized that Hispanic-Latino (HL), Non-Hispanic (NH), and African-American (AA) race impacts the clinical presentation of HCM.</p><p><strong>Methods: </strong>A total of 641 HCM patients (HL = 294, NH = 274, AA = 73) were identified retrospectively from our institutional registry between 2005-2021. Clinical characteristics, echocardiographic indices, and outcomes were assessed using analysis of variance, Kruskal-Wallis, and multivariate linear regression statistical analyses, with Dunn-Bonferroni and Tukey test applied in post-hoc pairwise assessments.</p><p><strong>Results: </strong>The HL and NH patients were older compared with AA (69.2 ± 14.7 vs 67.9 ± 15.3 vs 59.4 ± 15.8 years; <i>p</i> < 0.001). The HL group had higher prevalence of females compared with NH (62 vs 47%; <i>p</i> = 0.002), and more moderate-severe mitral regurgitation (35 vs 23 vs 12% <i>p</i> < 0.001) and a higher E/e' ratio (16.4 ± 8.1 vs 14.9 ± 6.6 vs 13.3 ± 4.5; <i>p</i> = 0.002) when compared with NH and AA. Multivariate linear regression analysis revealed HL ethnicity (β = 0.1) was associated with worse New York Heart Association (NYHA) class independent from moderate-severe mitral regurgitation (β = 0.2), chronic obstructive pulmonary disease (β = 0.17), female gender (β = 0.13), coronary artery disease (β = 0.12), atrial fibrillation (β = 0.11), peak trans-mitral E-wave velocity (β = 0.11), left ventricular mass index (β = 0.1), and reverse septal curve morphology (β = 0.1) (model, r = 0.5, <i>p</i> < 0.001). At 2.5-year median follow-up, all-cause mortality (8%) and composite complications (33%) were similar across the cohort.</p><p><strong>Conclusions: </strong>HCM patients of HL race have worse heart failure symptoms when compared with NH and AA, with severity independent of cardiovascular co-morbidities.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 2","pages":"26588"},"PeriodicalIF":1.9000,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868878/pdf/","citationCount":"0","resultStr":"{\"title\":\"Hispanic-Latino Race is Associated with Worse Heart Failure Symptoms in Patients with Hypertrophic Cardiomyopathy.\",\"authors\":\"Reshma Golamari, Alexander Khodak, Steven D Hartman, Marissa Donatelle, Tarec K Elajami, Rafle Fernandez, Christos G Mihos\",\"doi\":\"10.31083/RCM26588\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Data regarding racial differences in patients with hypertrophic cardiomyopathy (HCM) is sparse. We hypothesized that Hispanic-Latino (HL), Non-Hispanic (NH), and African-American (AA) race impacts the clinical presentation of HCM.</p><p><strong>Methods: </strong>A total of 641 HCM patients (HL = 294, NH = 274, AA = 73) were identified retrospectively from our institutional registry between 2005-2021. Clinical characteristics, echocardiographic indices, and outcomes were assessed using analysis of variance, Kruskal-Wallis, and multivariate linear regression statistical analyses, with Dunn-Bonferroni and Tukey test applied in post-hoc pairwise assessments.</p><p><strong>Results: </strong>The HL and NH patients were older compared with AA (69.2 ± 14.7 vs 67.9 ± 15.3 vs 59.4 ± 15.8 years; <i>p</i> < 0.001). The HL group had higher prevalence of females compared with NH (62 vs 47%; <i>p</i> = 0.002), and more moderate-severe mitral regurgitation (35 vs 23 vs 12% <i>p</i> < 0.001) and a higher E/e' ratio (16.4 ± 8.1 vs 14.9 ± 6.6 vs 13.3 ± 4.5; <i>p</i> = 0.002) when compared with NH and AA. Multivariate linear regression analysis revealed HL ethnicity (β = 0.1) was associated with worse New York Heart Association (NYHA) class independent from moderate-severe mitral regurgitation (β = 0.2), chronic obstructive pulmonary disease (β = 0.17), female gender (β = 0.13), coronary artery disease (β = 0.12), atrial fibrillation (β = 0.11), peak trans-mitral E-wave velocity (β = 0.11), left ventricular mass index (β = 0.1), and reverse septal curve morphology (β = 0.1) (model, r = 0.5, <i>p</i> < 0.001). At 2.5-year median follow-up, all-cause mortality (8%) and composite complications (33%) were similar across the cohort.</p><p><strong>Conclusions: </strong>HCM patients of HL race have worse heart failure symptoms when compared with NH and AA, with severity independent of cardiovascular co-morbidities.</p>\",\"PeriodicalId\":20989,\"journal\":{\"name\":\"Reviews in cardiovascular medicine\",\"volume\":\"26 2\",\"pages\":\"26588\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2025-02-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868878/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Reviews in cardiovascular medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.31083/RCM26588\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/2/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Reviews in cardiovascular medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.31083/RCM26588","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/2/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
摘要
背景:肥厚性心肌病(HCM)患者的种族差异数据很少。我们假设西班牙-拉丁裔(HL)、非西班牙裔(NH)和非裔美国人(AA)种族影响HCM的临床表现。方法:回顾性分析2005-2021年间来自我们机构登记的641例HCM患者(HL = 294, NH = 274, AA = 73)。采用方差分析、Kruskal-Wallis和多元线性回归统计分析评估临床特征、超声心动图指标和结果,并采用Dunn-Bonferroni和Tukey检验进行事后两两评估。结果:与AA相比,HL和NH患者年龄较大(69.2±14.7岁vs 67.9±15.3岁vs 59.4±15.8岁);P < 0.001)。HL组女性患病率高于NH组(62% vs 47%;p = 0.002),中重度二尖瓣返流较多(35 vs 23 vs 12% p < 0.001), E/ E′比较高(16.4±8.1 vs 14.9±6.6 vs 13.3±4.5;p = 0.002)。多因素线性回归分析显示,HL种族(β = 0.1)与较差的纽约心脏协会(NYHA)分级相关,与中重度二尖瓣反流(β = 0.2)、慢性阻塞性肺疾病(β = 0.17)、女性(β = 0.13)、冠状动脉疾病(β = 0.12)、心房纤颤(β = 0.11)、二尖瓣e波峰值速度(β = 0.11)、左心室质量指数(β = 0.1)和中隔反向曲线形态(β = 0.1)无关(模型,r = 0.5,P < 0.001)。中位随访2.5年,全因死亡率(8%)和复合并发症(33%)在整个队列中相似。结论:HL人种HCM患者心衰症状较NH和AA加重,且严重程度与心血管合并症无关。
Hispanic-Latino Race is Associated with Worse Heart Failure Symptoms in Patients with Hypertrophic Cardiomyopathy.
Background: Data regarding racial differences in patients with hypertrophic cardiomyopathy (HCM) is sparse. We hypothesized that Hispanic-Latino (HL), Non-Hispanic (NH), and African-American (AA) race impacts the clinical presentation of HCM.
Methods: A total of 641 HCM patients (HL = 294, NH = 274, AA = 73) were identified retrospectively from our institutional registry between 2005-2021. Clinical characteristics, echocardiographic indices, and outcomes were assessed using analysis of variance, Kruskal-Wallis, and multivariate linear regression statistical analyses, with Dunn-Bonferroni and Tukey test applied in post-hoc pairwise assessments.
Results: The HL and NH patients were older compared with AA (69.2 ± 14.7 vs 67.9 ± 15.3 vs 59.4 ± 15.8 years; p < 0.001). The HL group had higher prevalence of females compared with NH (62 vs 47%; p = 0.002), and more moderate-severe mitral regurgitation (35 vs 23 vs 12% p < 0.001) and a higher E/e' ratio (16.4 ± 8.1 vs 14.9 ± 6.6 vs 13.3 ± 4.5; p = 0.002) when compared with NH and AA. Multivariate linear regression analysis revealed HL ethnicity (β = 0.1) was associated with worse New York Heart Association (NYHA) class independent from moderate-severe mitral regurgitation (β = 0.2), chronic obstructive pulmonary disease (β = 0.17), female gender (β = 0.13), coronary artery disease (β = 0.12), atrial fibrillation (β = 0.11), peak trans-mitral E-wave velocity (β = 0.11), left ventricular mass index (β = 0.1), and reverse septal curve morphology (β = 0.1) (model, r = 0.5, p < 0.001). At 2.5-year median follow-up, all-cause mortality (8%) and composite complications (33%) were similar across the cohort.
Conclusions: HCM patients of HL race have worse heart failure symptoms when compared with NH and AA, with severity independent of cardiovascular co-morbidities.
期刊介绍:
RCM is an international, peer-reviewed, open access journal. RCM publishes research articles, review papers and short communications on cardiovascular medicine as well as research on cardiovascular disease. We aim to provide a forum for publishing papers which explore the pathogenesis and promote the progression of cardiac and vascular diseases. We also seek to establish an interdisciplinary platform, focusing on translational issues, to facilitate the advancement of research, clinical treatment and diagnostic procedures. Heart surgery, cardiovascular imaging, risk factors and various clinical cardiac & vascular research will be considered.