{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T17:57:02Z","timestamp":1792000622631,"version":"4.4.0"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"13","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,7,7]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Female sex has been associated with poor prognosis in hypertrophic cardiomyopathy (HCM), but the factors contributing to this disparity remain insufficiently defined. We aimed to clarify sex differences in clinical characteristics and factors associated with cardiovascular death in Japan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">This multicenter, retrospective observational study of HCM was conducted between January 1, 2006, and December 31, 2018 (REVEAL\u2010HCM study [Multicenter Registry to Evaluate Risk Factors for Disease Progression, Sudden Cardiac Death and Adverse Clinical Outcomes in Japanese Patients With Hypertrophic Cardiomyopathy]; UMIN000046932). Patients aged \u226516\u2009years with HCM were enrolled. Baseline characteristics and clinical outcomes including cardiovascular death were assessed. Univariable and multivariable Cox proportional hazards models were used to identify factors associated with cardiovascular death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Of 3247 patients (median age, 67\u2009years; 43% women), women were older and more symptomatic at presentation (52% New York Heart Association class II\u2013IV versus 35% in men). Cardiovascular death was more common in women (hazard ratio [HR], 1.37 [95% CI, 1.02\u20131.82];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.03). In multivariable analysis, older age (per 1\u2010year increase; HR, 1.04 [95% CI, 1.02\u20131.06]), advanced New York Heart Association class (HR, 1.99 [95% CI, 1.40\u20132.82]), history of atrial fibrillation (HR, 1.55 [95% CI, 1.10\u20132.18]), greater maximal wall thickness indexed to body surface area (per 1\u2010mm\/m\n                      <jats:sup>2<\/jats:sup>\n                      increase; HR, 1.12 [95% CI, 1.06\u20131.20]), and apical HCM (HR, 0.53 [95% CI, 0.32\u20130.88]) were independently associated with cardiovascular death, attenuating the HR for female sex.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Sex differences in clinical characteristics and outcomes were observed. The excess cardiovascular death in women with HCM was largely explained by older age, more advanced symptoms, greater indexed wall thickness, and sex\u2010specific differences in both the prevalence and prognostic impact of apical HCM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.046708","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T10:37:24Z","timestamp":1782211044000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Sex Differences in Characteristics and Outcomes Among Patients With Hypertrophic Cardiomyopathy: Insights From the REVEAL\u2010HCM Study"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-7224-7739","authenticated-orcid":false,"given":"Masayuki","family":"Nakamura","sequence":"first","affiliation":[{"name":"NHO Osaka National Hospital","place":["Osaka, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1579-0071","authenticated-orcid":false,"given":"Haruhiko","family":"Abe","sequence":"additional","affiliation":[{"name":"NHO Osaka National Hospital","place":["Osaka, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0514-106X","authenticated-orcid":false,"given":"Yasunori","family":"Ueda","sequence":"additional","affiliation":[{"name":"NHO Osaka National Hospital","place":["Osaka, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0529-7125","authenticated-orcid":false,"given":"Hiroaki","family":"Kitaoka","sequence":"additional","affiliation":[{"name":"Kochi University","place":["Kochi, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5618-4721","authenticated-orcid":false,"given":"Yasushi","family":"Sakata","sequence":"additional","affiliation":[{"name":"Osaka University Graduate School of Medicine","place":["Osaka, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5078-6326","authenticated-orcid":false,"given":"Kaoru","family":"Dohi","sequence":"additional","affiliation":[{"name":"Mie University Graduate School of Medicine","place":["Tsu, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9897-0918","authenticated-orcid":false,"given":"Yukichi","family":"Tokita","sequence":"additional","affiliation":[{"name":"Nippon Medical School","place":["Tokyo, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8213-7999","authenticated-orcid":false,"given":"Takao","family":"Kato","sequence":"additional","affiliation":[{"name":"Kyoto University Graduate School of Medicine","place":["Kyoto, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9774-4513","authenticated-orcid":false,"given":"Shouji","family":"Matsushima","sequence":"additional","affiliation":[{"name":"Kyushu University","place":["Fukuoka, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masashi","family":"Amano","sequence":"additional","affiliation":[{"name":"National Cerebral and Cardiovascular Center","place":["Suita, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2416-5865","authenticated-orcid":false,"given":"Takeshi","family":"Kitai","sequence":"additional","affiliation":[{"name":"National 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Comprehensive Survey of Living Conditions 2019. Ministry of Health Labour and Welfare website . 2020. Accessed May 22 2026. https:\/\/www.mhlw.go.jp\/toukei\/saikin\/hw\/k\u2010tyosa\/k\u2010tyosa19\/index.html."},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2012-000958"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2015.04.026"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.124.038421"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2025.08.005"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa021332"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0232427"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.125.046708","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T04:38:56Z","timestamp":1787719136000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.125.046708"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,7]]},"references-count":37,"journal-issue":{"issue":"13","published-print":{"date-parts":[[2026,7,7]]}},"alternative-id":["10.1161\/JAHA.125.046708"],"URL":"https:\/\/doi.org\/10.1161\/jaha.125.046708","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,7]]},"assertion":[{"value":"2025-12-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e046708"}}