Cardiology · 3 h ago
Septal thickening was more strongly associated with mortality in women with heart failure
A retrospective registry study of 20,836 patients with heart failure found that greater interventricular septal thickness was associated with higher four-year mortality. The association was stronger in women than men when the same thickness thresholds were applied to both sexes, although results varied when sex-specific reference partitions were used.
- Registry study included 20,836 patients with heart failure.
- Four-year mortality increased across septal-thickness categories.
- Adjusted associations were stronger in women than men.
- Results depended on use of common thickness thresholds.
Researchers analyzed patients with heart failure in the SHEBAHEART registry from 2009 to 2025. Interventricular septal (IVS) thickness measured by echocardiography was categorized as normal (<1.1 cm), mildly thickened (1.1–1.3 cm), or severely thickened (>1.3 cm), using the same thresholds for women and men. The primary complete-case analysis included 13,902 patients; models adjusted for demographic and clinical factors, including age, comorbidities, and left ventricular ejection fraction.
Among all 20,836 patients (median age 74 years; 39% women), 41% had mild and 18% severe thickening. Over a median four-year follow-up, 11,930 patients died. Four-year cumulative mortality rose from 35% with normal thickness to 39% with mild and 42% with severe thickening. In adjusted analyses, mild and severe thickening were associated with higher mortality in women (hazard ratios 1.16 and 1.19), but estimates in men were smaller and not statistically significant (1.02 and 1.07). The sex-by-thickness interaction was significant in the primary analysis (P=0.030).
The retrospective findings suggest IVS thickness may contribute to sex-specific risk assessment in heart failure, but do not establish clinical utility. The interaction was not significant when sex-specific reference partitions were used; the study assessed mortality associations, not whether changing management based on thickness improves outcomes.
In practice
In adults with heart failure, greater interventricular septal thickness using common absolute thresholds was associated with higher all-cause mortality, with stronger adjusted associations in women than in men. This may support further evaluation of IVS thickness in sex-specific risk assessment, but the study does not show that it improves prediction or that management should change. It was retrospective, and the interaction was not significant when sex-specific reference partitions were used.
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ESC Heart Failure: Sex-Specific Prognostic Significance of Interventricular Septal Thickness in Heart Failure ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.