Title: Diagnosing DCM – does sex matter? 

Abstract:  

What Is New? 

Among individuals with autosomal dominant inheritance of dilated cardiomyopathy (DCM), an equal sex distribution is expected. We systematically evaluated the sex ratio in DCM (n=37 525), finding that all-cause, monogenic, and gene-elusive DCM are characterized by a ≈2:1 male to female ratio.          

The sex imbalance partially corrects on implementing novel sex-specific diagnostic criteria (UK Biobank [n=47 549]), suggesting that DCM may not be adequately detected in female patients, leading to underdiagnosis. 

The sex imbalance does not fully correct, suggesting that male patients are either more susceptible to DCM due to genetic or environmental factors or that female patients are protected in some way. 

What Are the Clinical Implications?      

Increased clinical vigilance may be required to diagnose DCM in female patients across the disease spectrum. 

The application of sex-specific DCM diagnostic criteria should be evaluated.          

Genetic, reproductive, and environmental factors contributing to differences in disease risk in male and female patients should be explored. 

Biography: 

Dr Paz (Upasana) Tayal is an MRC clinician scientist and Associate Professor at the National Heart and Lung Institute and a consultant cardiologist specialising in cardiomyopathy. 

Dr Tayal graduated from the University of Oxford with Merit and completed Academic Foundation training in Oxford before moving to London to continue clinical training at Hammersmith Hospital, and Royal Brompton and Harefield hospitals. 

In 2014 she was awarded an MRC Clinical Research Training Fellowship to do a PhD at Imperial College, evaluating the integrated genetic and phenotypic assessment of dilated cardiomyopathy. This work was awarded the National Heart Lung Institute Best Thesis Prize in 2018. 

In 2022 she was awarded an MRC Clinician Scientist Fellowship to develop her programme of research evaluating sex specific differences in patients with cardiomyopathy, with the aim of improving outcomes for all patients affected by these conditions. Her research has been published in high impact journals and has been incorporated into international clinical guidelines. 

She has held a number of national committee and leadership roles including the Royal Society of Medicine (former President of the RSM Trainees' Section), The Royal Society (Diversity Committee), and the British Cardiovascular Society (Clinical Standards and Programme Committee). She is a Research Editor for The British Medical Journal.