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Heart, Lung and Circulation

015 Clinical Profile and Management of Hypertrophic Cardiomyopathy in a Multi-Ethnic Australian Cohort

  • A. Butters
    Affiliations
    Agnes Ginges Centre for Molecular Cardiology, The University of Sydney, Sydney, Australia

    Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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  • C. Semsarian
    Affiliations
    Agnes Ginges Centre for Molecular Cardiology, The University of Sydney, Sydney, Australia

    Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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  • R. Bagnall
    Affiliations
    Agnes Ginges Centre for Molecular Cardiology, The University of Sydney, Sydney, Australia

    Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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  • L. Yeates
    Affiliations
    Agnes Ginges Centre for Molecular Cardiology, The University of Sydney, Sydney, Australia

    Faculty of Medicine and Health, University of Sydney, Sydney, Australia

    Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia
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  • F. Stafford
    Affiliations
    Agnes Ginges Centre for Molecular Cardiology, The University of Sydney, Sydney, Australia
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  • C. Burns
    Affiliations
    Agnes Ginges Centre for Molecular Cardiology, The University of Sydney, Sydney, Australia

    Faculty of Medicine and Health, University of Sydney, Sydney, Australia

    Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia
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  • C. Semsarian
    Affiliations
    Agnes Ginges Centre for Molecular Cardiology, The University of Sydney, Sydney, Australia

    Faculty of Medicine and Health, University of Sydney, Sydney, Australia

    Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia
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  • J. Ingles
    Affiliations
    Agnes Ginges Centre for Molecular Cardiology, The University of Sydney, Sydney, Australia

    Faculty of Medicine and Health, University of Sydney, Sydney, Australia

    Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia
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Published:November 08, 2020DOI:https://doi.org/10.1016/j.hlc.2020.09.022

      Background

      The clinical characteristics and management of hypertrophic cardiomyopathy (HCM) are well-described in European cohorts. However, less is known about other ethnic groups. We compared demographic, clinical, genetic and service use characteristics of HCM patients across the major ethnic groups represented in our multi-ethnic Australian cohort.

      Methods and Results

      A total of 812 probands attending a specialised HCM clinic in Sydney between 2002 and 2020 were included. The major ethnic groups were European (EUR) (n=611), East Asian (EAS) (n=75), South Asian (SAS) (n=58) and Middle Eastern and North African (MENA) (n=68). The mean age was 54.9±16.9 years and 527 (64.9%) were male. Patients of each ethnic group differed in age (p=0.028), body mass index (p<0.0001) and prevalence of atrial fibrillation (p=0.024). Further, there were differences in baseline echocardiographic parameters, including maximum left ventricular (LV) wall thickness (p=0.013), hypertrophy pattern (p<0.0001), LV systolic (p=0.003) and diastolic diameter (p=0.021) and LV outflow tract obstruction (p=0.009). Rates of implantable cardioverter defibrillator use differed (p=0.037), as did rates of genetic testing uptake (p<0.0001). Yield of genetic testing results also varied (p<.0001), and the distribution of causative genes also differed (p=0.0003).

      Conclusion

      We demonstrate variability in the phenotype expression and management of HCM amongst ethnic groups, representing differences in pathophysiology, sociocultural contexts, and access to healthcare. This may indicate a role of ethnicity in understanding the clinical course of HCM, and highlight inequities faced by some groups.
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