Table 1.

Study characteristics

Study	Country	Study type	Inclusion	Study size	Baseline comorbidities (female/male)								Follow-up (years)	Conclusions
					female (%)	age (mean ± SD)	CAD (%)	AF (%)	NYHA, III-IV (%)	ICD (%)	LVEF (mean ± SD)	LVOT gradient* (mean ± SD)
Ghiselli et al. [22]	Italy	Retrospective cohort	HCM without obstructive CAD	292	27.7	51±16/44±17	0/0	10/11	11/6	1/3	67±6/67±7	14±15/18±20	5.9±4.2	Women were at greater risk of HCM-related complications and death. Impaired exercise capacity predicted adverse outcome only in men
Ho et al. [23]	China	Retrospective cohort	HCM without obstructive CAD	118	47.4	56±14/52±13	0/0	N/A	25/22.6	N/A	68±12/72±12	N/A	5.8±4.3	HCM in Chinese patients is characterized by late onset, high incidence of the apical form, and adverse outcome in females
Huang et al. [12]	China	Retrospective cohort	HCM	576	45.1	57±17/53±16	16.5/16.5	18.5/10.8	46.9/30.7	4.2/6	66.9±8.2/66.4±9.4	Median 33/24	3.2±2.3	Female patients with HCM were older and more symptomatic at presentation with higher risk of progress to HF, but no differences in CV death
Huurman et al. [24]	The Netherlands	Retrospective cohort	HCM with septal myectomy	162	38.9	57±15/49±14	N/A	19/20	79.3/76.8	11/15	N/A	93±34/83±33	Median 5.9 (IQR 3–9.1)	Female patients with HCM present later in life and have more advanced disease on echocardiography. However, time until myectomy was similar and clinical outcomes after surgery were favorable in both women and men
Lu et al. [25]	USA	Retrospective cohort	HCM	728 (400 age-matched patients)	38	57±15/51±14	8/10	N/A	21/7	N/A	67±8/65±8	35±34/26±29	Median 2.1 (IQR 1–4.7)	Sex-specific differences in LV geometry, hyper-contractility, and diastolic function, but not greater degree of LV myopathy contribute to a higher, age-independent risk of diastolic HF in women with HCM
Meghji et al. [26]	USA	Retrospective cohort	HCM with extended transaortic septal myectomy	2,506	45	Median 59.5/52.9	N/A	18.1/20.4	90.8/84.8	12.8/14.2	Median 73/70	Median 67/50	Median 8.2 (IQR 3.1–13.2)	Women were older and more symptomatic. However, after adjusted baseline prognostic factors, there were no survival differences after septal myectomy
Montenegro Sa et al. [27]	Portugal	Retrospective cohort	HCM	1,042	41.2	56±17/51±15	2.616.7	29.8/26.1	10.8/16.1	10.7/15.3	65.6±11/64.3±11	17±16/15±16	5.4±6.2 5	Female sex was an independent predictor of overall and C V-related death, with more HF-related death
Rowin et al. [28]	USA	Retrospective cohort	HCM	2,123	37.4	50±19/44±16	7/6	25/26	39/23	24/25	64±7/63±6	N/A	4.7±3.5	Survival was not less favorable in women with HCM. Often, women were underrecognized and referred to centers later than men
Terauchiet al. [29]	Japan	Retrospective cohort	HCM with MYBPC3 mutation without CAD	50	46	50±19/45±14	0/0	13/11	8/0	N/A	67±ll/65±9	N/A	13±8	Females with MYBPC3 mutation showed later onset of disease, had more symptomatic at diagnosis and more frequent HF
van Velzen et al. [11]	The Netherlands	Retrospective cohort	HCM	1,007	38.4	56±16/49±15	5/7	23/20	N/A	6/4	N/A	N/A	Median 6.8 (IQR 3.2–10.9)	Females with HCM presented at a more advanced age with a different clinical, phenotypic, and genetics status but no association with all-cause mortality, CV mortality, HF-related mortality, or SCD.
Wang et al. [30]	China	Retrospective cohort	HCM without bbc NYHA class III or IV	621	25.9	50±17/47±14	13.0/14.6	11.8/12.8	0/0	0.6/0.7	67.1±8.5/67.5±7.8	N/A	Mean 4 (range 2–7)	Female sex is associated with worse survival and HF in patients with HCM

AF, atrial fibrillation; CAD, coronary artery disease; CV, cardiovascular; F, female; HCM, hypertrophic cardiomyopathy; HF, heart failure; ICD, implantable cardioverter defibrillator; IQR, interquartile range; LV, left ventricle; LVEF, left ventricular ejection fraction; LVOT, left ventricular outflow tract; M, male; N/A, not available; NYHA, New York Heart Association; SD, standard deviation; SCD, sudden cardiac death.

^*LVOT gradient reference unit is mm Hg.