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Agnes Ginges Centre for Molecular Cardiology, The University of Sydney, Sydney, AustraliaFaculty of Medicine and Health, University of Sydney, Sydney, Australia
Agnes Ginges Centre for Molecular Cardiology, The University of Sydney, Sydney, AustraliaFaculty of Medicine and Health, University of Sydney, Sydney, Australia
Agnes Ginges Centre for Molecular Cardiology, The University of Sydney, Sydney, AustraliaFaculty of Medicine and Health, University of Sydney, Sydney, Australia
Agnes Ginges Centre for Molecular Cardiology, The University of Sydney, Sydney, AustraliaFaculty of Medicine and Health, University of Sydney, Sydney, AustraliaDepartment of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia
Agnes Ginges Centre for Molecular Cardiology, The University of Sydney, Sydney, AustraliaFaculty of Medicine and Health, University of Sydney, Sydney, AustraliaDepartment of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia
Agnes Ginges Centre for Molecular Cardiology, The University of Sydney, Sydney, AustraliaFaculty of Medicine and Health, University of Sydney, Sydney, AustraliaDepartment of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia
Agnes Ginges Centre for Molecular Cardiology, The University of Sydney, Sydney, AustraliaFaculty of Medicine and Health, University of Sydney, Sydney, AustraliaDepartment of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia
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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