ArticleJournal of the American College of Cardiology2025
Demographic-Based Personalized Left Ventricular Hypertrophy Thresholds for Hypertrophic Cardiomyopathy Diagnosis.
Article in Journal of the American College of Cardiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Sex-disaggregated data in hypertrophic cardiomyopathy: a targeted literature review, meta-analysis and primary cohort study.Open heart · 2026Pooled it
- Complication management in hypertrophic cardiomyopathy.Heart failure reviews · 2026Review
- Transthyretin Amyloid Cardiomyopathy in Women: Epidemiology, Diagnostic Delay, and Clinical Implications.Cardiology and therapy · 2026Review
- Imaging-Based Risk Stratification for Sudden Cardiac Death in Hypertrophic Cardiomyopathy: Current Evidence and Clinical Perspectives.Medical sciences (Basel, Switzerland) · 2026Review
- Sex Differences in Characteristics and Outcomes Among Patients With Hypertrophic Cardiomyopathy: Insights From the REVEAL-HCM Study.Journal of the American Heart Association · 2026Observational
- Unveiling sex dimorphism in the healthy cardiac anatomy: Fundamental differences between male and female heart shapes.The Journal of physiology · 2026Article
- Beyond sarcomere genetics: proteomic insights into hypertrophic cardiomyopathy.Biophysical reviews · 2026Review
- The prospective Austrian hypertrophic cardiomyopathy registry - design, methods and results of the run-in period.Heart failure reviews · 2026Article
- Polygenic Background and Penetrance of Pathogenic Variants in Hypertrophic and Dilated Cardiomyopathies.JAMA cardiology · 2026Article
- Independent association of leg-height ratio with 15 cardiometabolic diseases.Cardiovascular diabetology · 2026Article
- Optimizing imaging techniques in hypertrophic cardiomyopathy: challenges and opportunities.European heart journal. Imaging methods and practice · 2026Review
- Multimodality Imaging in Hypertrophic Cardiomyopathy.Cardiac failure review · 2026Review
- Hypertrophic Cardiomyopathy in the Era of Precision Medicine: Redefining Diagnosis, Therapeutics and Risk.Cardiac failure review · 2026Article
- Breaking the Cycle: Why Women of Reproductive Age Belong in All Areas of Health Research.BJOG : an international journal of obstetrics and gynaecology · 2025Article
- Exploring Morphologic and Functional Variants in Hypertrophic Cardiomyopathy: An Echocardiographic and Doppler Review.Diagnostics (Basel, Switzerland) · 2025Review
- Cardiac Magnetic Resonance in the Evaluation and Management of Nonischemic Cardiomyopathies.JACC. Heart failure · 2025Review
- Hypertrophic cardiomyopathy.Nature reviews. Disease primers · 2025Review
- Countywide burden, pathology, and genetics of lethal hypertrophic cardiomyopathy: from the POST SCD study.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Article
- A Practical Approach to Multimodality Imaging in Hypertrophic Cardiomyopathy.Journal of clinical medicine · 2025Review
- The Utility of Nuclear Imaging in Hypertrophic Cardiomyopathy: A Narrative Review.Journal of clinical medicine · 2025Review
Corrections and comments
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Authors and funding
33 authors.
Funding
Abstract
backgroundHypertrophic cardiomyopathy (HCM) is a leading cause of sudden cardiac death. Current diagnosis emphasizes the detection of left ventricular hypertrophy (LVH) using a fixed threshold of ≥15-mm maximum wall thickness (MWT). This study proposes a method that considers individual demographics to adjust LVH thresholds as an alternative to a 1-size-fits-all approach.
methodsLeft ventricular MWT was measured in 3 cohorts: a Reference Cohort of healthy adults (n = 5,067, no comorbidities), a Population Cohort (n = 43,239, with comorbidities), and an HCM Cohort from 6 international centers (n = 2,424). Measurement used cardiovascular magnetic resonance (CMR) and a validated artificial intelligence algorithm. The Reference Cohort was used to developed demographically adjusted LVH thresholds, and individualized z-scores based on age, sex, and body surface area (BSA), which were used to explore the other cohorts.
resultsThe traditional ≥15-mm threshold classified 4.3% (n = 1,854) of the Population Cohort as hypertrophic, with a significant sex skew (89% male). Demographic-adjusted LVH thresholds (range: 10-17 mm) reduced ascertainment to 2.2% (n = 945), reducing the sex skew (56% male). Similar reductions in bias with height, weight, and age also occurred. The HCM cohort was found to have a 2:1 male-to-female ratio. A significant proportion of patients received diagnoses of HCM despite having MWT below the traditional LVH threshold (<15 mm): 27% of female individuals and 18% of male individuals. Using demographic-adjusted LVH thresholds reduced these proportions to 7% of female individuals and 15% of male individuals (P < 0.0001). Female patients had lower absolute MWT (18 mm vs 19 mm; P < 0.001) but higher MWT z-scores (5.1 vs 4.5; P = 0.05).
conclusionsAge, sex, and body size influence the normal heart MWT. Using a fixed LVH threshold ≥15 mm biases LVH ascertainment in both population and HCM cohorts. A demographic-adjusted approach for LVH improves ascertainment and diagnostic accuracy.
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