Table 3.
Characteristics of HCM Patients in Different Regions in Japan
| Variables | Hokkaido/ Tohoku (n=1,049) |
Kanto (n=894) |
Chubu (n=372) |
Kinki (n=555) |
Chugoku/ Shikoku (n=277) |
Kyushu (n=406) |
P value |
|---|---|---|---|---|---|---|---|
| Demographics | |||||||
| Age at enrollment (years) | 67 [58–75] |
62 [47–71] |
64 [53–73] |
64 [53–73] |
62 [54–72] |
63 [54–73] |
<0.001 |
| Age at diagnosis (years) | 56 [45–64] |
52 [38–63] |
56 [40–65] |
53 [40–65] |
55 [43–65] |
56 [43–65] |
0.001 |
| Male sex | 663 (63.2) | 527 (59.0) | 204 (54.8) | 291 (52.4) | 164 (59.2) | 238 (58.6) | 0.001 |
| NYHA functional class | |||||||
| I | 346 (35.7) | 220 (27.8) | 69 (20.1) | 104 (20.6) | 60 (23.9) | 74 (20.4) | <0.001 |
| II | 558 (57.6) | 493 (62.3) | 214 (62.2) | 317 (62.7) | 155 (61.8) | 249 (68.6) | <0.001 |
| III | 59 (6.1) | 69 (8.7) | 50 (14.5) | 74 (14.6) | 33 (13.2) | 34 (9.4) | <0.001 |
| IV | 5 (0.5) | 9 (1.1) | 11 (3.2) | 11 (2.2) | 3 (1.2) | 6 (1.7) | <0.001 |
| Syncope | 141 (13.4) | 193 (21.6) | 80 (21.5) | 125 (22.5) | 51 (18.4) | 66 (16.3) | <0.001 |
| Family history | |||||||
| HCM | 144 (13.7) | 199 (22.3) | 95 (25.5) | 135 (24.3) | 59 (21.3) | 77 (19.0) | <0.001 |
| Sudden cardiac death | 36 (3.4) | 67 (7.5) | 33 (8.9) | 44 (7.9) | 26 (9.4) | 25 (6.2) | <0.001 |
| Vital signs | |||||||
| SBP (mmHg) | 122.6±18.5 | 121.0±20.4 | 119.5±20.3 | 120.5±21.2 | 122.0±19.9 | 121.0±20.4 | 0.11 |
| DBP (mmHg) | 70.5±12.3 | 71.6±15.3 | 69.9±13.0 | 70.5±15.2 | 70.0±12.3 | 70.5±14.7 | 0.33 |
| Abnormal BP response | 11 (1.1) | 28 (3.1) | 5 (1.3) | 12 (2.2) | 3 (1.1) | 17 (4.2) | <0.001 |
| Heart rate (beats/min) | 68.0±32.3 | 68.3±14.1 | 67.2±15.9 | 69.4±14.3 | 69.0±15.9 | 69.0±41.2 | 0.80 |
| Laboratory data | |||||||
| Hemoglobin (g/dL) | 13.7±1.9 | 13.9±1.8 | 13.5±2.0 | 13.7±1.9 | 13.7±1.8 | 13.8±1.7 | 0.029 |
| Albumin (g/dL) | 4.1±0.5 | 4.1±0.5 | 4.1±0.5 | 4.1±0.5 | 4.2±0.5 | 4.1±0.4 | 0.52 |
| AST (U/L) | 25.0 [21.0–32.0] |
24.0 [20.0–31.0] |
25.0 [20.0–32.0] |
24.0 [21.0–32.0] |
25.0 [21.0–32.0] |
25.0 [20.0–30.0] |
0.39 |
| ALT (U/L) | 21.0 [15.0–31.0] |
21.0 [15.0–31.0] |
21.0 [15.0–30.0] |
21.0 [15.0–31.0] |
22.0 [16.0–32.0] |
20.0 [15.0–29.0] |
0.55 |
| BUN (mg/dL) | 22.7±24.3 | 18.7±15.8 | 18.4±7.8 | 19.2±13.4 | 17.7±9.4 | 19.7±15.2 | <0.001 |
| Creatinine (mg/dL) | 0.88 [0.73–1.07] |
0.86 [0.71–1.04] |
0.87 [0.71–1.08] |
0.84 [0.70–1.00] |
0.83 [0.68–1.00] |
0.88 [0.72–1.05] |
0.025 |
| eGFR (mL/min/1.73 m2) | 62.6±21.5 | 65.7±21.2 | 62.4±20.2 | 65.0±21.0 | 66.6±20.8 | 62.6±21.6 | 0.002 |
| Uric acid (mg/dL) | 6.1±1.8 | 6.2±1.8 | 6.1±1.5 | 6.2±1.8 | 6.0±1.6 | 6.3±1.6 | 0.19 |
| Sodium (mEq/L) | 141.0±2.8 | 140.6±2.8 | 140.7±3.7 | 140.6±3.1 | 140.0±3.4 | 140.3±2.9 | <0.001 |
| BNP (pg/mL) | 194.1 [84.0–407.0] |
227.9 [100.8–511.0] |
320.0 [146.6–669.0] |
317.4 [120.0–626.0] |
297.7 [144.0–563.4] |
247.2 [100.5–480.2] |
<0.001 |
| Electrocardiographic findings | |||||||
| Atrial fibrillation | 264 (25.2) | 203 (22.7) | 121 (32.5) | 172 (31.0) | 81 (29.2) | 130 (32.0) | <0.001 |
| VF/VT | 208 (19.8) | 228 (25.5) | 101 (27.2) | 125 (22.5) | 72 (26.0) | 82 (20.2) | 0.006 |
| Pacing | 75 (7.2) | 42 (4.7) | 17 (4.6) | 15 (2.7) | 13 (4.7) | 18 (4.4) | 0.004 |
| Biventricular pacing | 9 (0.9) | 8 (0.9) | 2 (0.5) | 2 (0.4) | 3 (1.1) | 2 (0.5) | 0.76 |
| Echocardiographic findings | |||||||
| LVEF (%) | 62.7±14.8 | 62.1±16.9 | 63.8±15.0 | 61.1±16.1 | 62.7±14.9 | 63.6±15.0 | 0.14 |
| LVDd (mm) | 47.1±8.7 | 45.7±9.4 | 45.4±8.2 | 46.1±9.0 | 46.4±8.2 | 44.7±8.1 | <0.001 |
| LVDs (mm) | 30.4±9.6 | 30.0±10.6 | 29.4±9.7 | 29.8±9.9 | 29.6±8.9 | 28.5±9.4 | 0.054 |
| IVS (mm) | 16.2±5.4 | 15.7±5.5 | 16.7±5.8 | 15.4±4.6 | 16.6±5.1 | 16.5±5.2 | <0.001 |
| LVPW (mm) | 11.6±3.0 | 11.6±3.5 | 12.2±3.4 | 11.3±2.9 | 12.0±3.4 | 12.5±3.5 | <0.001 |
| Maximum LVWT (mm) | 18.9±5.7 | 19.0±6.5 | 19.7±6.5 | 18.4±4.9 | 18.6±5.5 | 18.8±5.2 | 0.11 |
| LVWT >30 mm | 66 (6.3) | 73 (8.2) | 42 (11.3) | 33 (6.0) | 24 (8.7) | 37 (9.1) | 0.017 |
| Left atrial diameter (mm) | 44.1±8.2 | 43.1±9.7 | 44.1±9.4 | 44.2±8.8 | 43.7±10.2 | 43.7±9.0 | 0.26 |
| MR Grade III–IV | 68 (10.0) | 38 (6.3) | 32 (10.8) | 39 (8.9) | 20 (9.0) | 28 (9.5) | 0.17 |
| LV obstruction | 174 (16.6) | 228 (25.5) | 101 (27.2) | 152 (27.4) | 77 (27.8) | 107 (26.4) | <0.001 |
| LVOT gradient >50 mmHg | 137 (13.1) | 203 (22.7) | 88 (23.7) | 128 (23.1) | 57 (20.6) | 77 (19.0) | <0.001 |
| LV mid-obstruction | 74 (7.1) | 102 (11.4) | 45 (12.1) | 59 (10.6) | 28 (10.1) | 46 (11.3) | 0.01 |
| Systolic anterior movement | 2 (0.2) | 7 (0.8) | 3 (0.8) | 4 (0.7) | 3 (1.1) | 1 (0.3) | 0.29 |
| Pericardial effusion | 20 (1.9) | 58 (6.5) | 33 (8.9) | 39 (7.0) | 26 (9.4) | 22 (5.4) | <0.001 |
| Apical hypertrophy | 7 (0.7) | 13 (1.5) | 1 (0.3) | 5 (0.9) | 4 (1.4) | 1 (0.3) | 0.13 |
| Medication | |||||||
| β-blockers | 558 (53.8) | 461 (52.9) | 214 (58.5) | 337 (60.9) | 153 (56.5) | 266 (65.7) | <0.001 |
| ACEi/ARB | 562 (53.6) | 430 (48.1) | 186 (50.0) | 251 (45.2) | 136 (49.1) | 196 (48.3) | 0.034 |
| MRA | 155 (14.8) | 137 (15.3) | 58 (15.6) | 95 (17.1) | 53 (19.1) | 56 (13.8) | 0.39 |
| Dihydropyridine CCB | 172 (16.4) | 94 (10.5) | 48 (12.9) | 58 (10.5) | 31 (11.2) | 60 (14.8) | <0.001 |
| Verapamil | 81 (7.7) | 48 (5.4) | 25 (6.7) | 56 (10.1) | 11 (4.0) | 33 (8.1) | 0.004 |
| Diltiazem | 55 (5.2) | 25 (2.8) | 19 (5.1) | 23 (4.1) | 2 (0.7) | 32 (7.9) | <0.001 |
| Loop diuretics | 314 (29.9) | 203 (22.7) | 119 (32.0) | 144 (26.0) | 72 (26.0) | 104 (25.6) | 0.002 |
| Thiazides | 47 (4.5) | 30 (3.4) | 23 (6.2) | 21 (3.8) | 10 (3.6) | 19 (4.7) | 0.29 |
| Digitalis | 46 (4.4) | 35 (3.9) | 14 (3.8) | 22 (4.0) | 13 (4.7) | 9 (2.2) | 0.52 |
| Amiodarone | 117 (11.3) | 102 (11.6) | 71 (19.1) | 64 (11.6) | 37 (13.6) | 40 (9.9) | 0.001 |
| Disopyramide | 61 (5.9) | 27 (3.1) | 11 (3.0) | 14 (2.5) | 16 (5.9) | 22 (5.4) | 0.002 |
| Cibenzoline | 157 (15.1) | 165 (18.8) | 64 (17.2) | 103 (18.7) | 43 (15.8) | 60 (14.8) | 0.2 |
| Oral inotropes | 13 (12.4) | 6 (1.5) | 6 (6.4) | 8 (3.3) | 5 (6.4) | 4 (3.2) | <0.001 |
Unless specified otherwise, data are given as n (%), the mean±SD, or as the median [interquartile range]. CCB, calcium channel blockers; LV, left ventricular; LVOT, left ventricular outflow tract; LVWT, left ventricular wall thickness; VF, ventricular fibrillation; VT, ventricular tachycardia. Other abbreviations as in Table 1.