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pmid:41322824

Racial, Sex, and Age Disparities in Cardiomyopathy Etiology: A Social Determinant Analysis of 366 Cardiac Patients.

Kiki J Estes-Schmalzl · Amy J Marcano-Reik · Kristin Lefebvre

Cureus · 2025 doi:10.7759/cureus.95664

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Experiment

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Data

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pmid:41322824
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2026-11-01T20:31:20Z
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2026-11-01T22:57:32Z
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title
Racial, Sex, and Age Disparities in Cardiomyopathy Etiology: A Social Determinant Analysis of 366 Cardiac Patients.
doi
10.7759/cureus.95664
pmid
41322824
authors array · 3 items
[0]
Kiki J Estes-Schmalzl
[1]
Amy J Marcano-Reik
[2]
Kristin Lefebvre
journal
Cureus
year
2025
abstract
BACKGROUND: Inequities in heart failure persist across race, sex, and age, but etiology-specific patterns in cardiomyopathies remain underexplored. We examined disparities across cardiomyopathy etiologies using a social determinants of health (SDoH) lens. METHODS: We analyzed 366 left ventricular tissue samples from the GEO dataset GSE141910, focusing on cardiomyopathy subtypes: dilated cardiomyopathy (DCM), hypertrophic cardiomyopathy (HCM), peripartum cardiomyopathy (PPCM), and nonfailing controls. Demographics included race (African American, Caucasian), sex, and age. We compared distributions using χ² or Fisher's exact tests and assessed age differences with t-tests/analysis of variance. RESULTS: African Americans showed a 1.69-fold higher prevalence of DCM vs. Caucasians (62.1%, n = 77 vs. 36.8%, n = 89; χ² = 27.101, df = 2, p < 0.001, Cramér's V = 0.272) and presented 5.9 years earlier (48.9 ± 12.9 years, n = 77 vs. 54.8 ± 7.1 years, n = 89; p < 0.001, Cohen's d = -0.572). HCM was 13.8-fold more common in Caucasians (11.2%, n = 27 vs. 0.8%, n = 1; Fisher's exact p < 0.001). PPCM occurred exclusively in women and was nearly twofold more frequent among African Americans (62.5%, n = 5 of 8 PPCM cases), who also presented younger than Caucasians (29.5 years, n = 2 vs. 37.2 years, n = 4). Male sex was associated with higher DCM prevalence (51.5%, n = 100 vs. 38.4%, n = 66; χ² = 13.845, df = 3, p = 0.016, Cramér's V = 0.194) and predominated in HCM (60.7%, n = 17). Intersectional analyses revealed disproportionate burden among younger African Americans; among DCM patients <45 years, 71.4% (n = 15 of 21) were African Americans. CONCLUSIONS: Cardiomyopathy etiology is associated with systematic demographic patterns. African Americans are more likely to experience earlier onset and greater DCM burden, while Caucasians exhibit markedly higher HCM prevalence. Male sex is disproportionately represented in DCM and HCM. These findings are consistent with SDoH-driven inequities and underscore the need for earlier detection, equity-centered prevention, and improved access to specialized diagnostics and therapies.
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Group differences were assessed using χ² tests for categorical variables (or Fisher's exact test when expected cell counts were <5) and independent t-tests or one-way analysis of variance with Tukey's post hoc comparisons for continuous variables.
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sections[2] "Materials and methods" paragraph 17
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Group differences were assessed using χ² tests for categorical variables (or Fisher's exact test when expected cell counts were <5) and independent t-tests or one-way analysis of variance with Tukey's post hoc comparisons for continuous variables.
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This cross-sectional retrospective analysis used publicly available, deidentified data from the GEO dataset GSE141910 (National Center for Biotechnology Information, Bethesda, Maryland, United States), comprising left ventricular myocardial tissue samples collected from multiple centers.
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sections[2] "Materials and methods" paragraph 3
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This cross-sectional retrospective analysis used publicly available, deidentified data from the GEO dataset GSE141910 (National Center for Biotechnology Information, Bethesda, Maryland, United States), comprising left ventricular myocardial tissue samples collected from multiple centers.
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Etiology distributions differed significantly by race (χ² = 27.10, df = 2, p < 0.001, Cramér's V = 0.272).
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Etiology distributions differed significantly by race (χ² = 27.10, df = 2, p < 0.001, Cramér's V = 0.272).
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sections[3] "Results" paragraph 4
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Etiology distributions differed significantly by race (χ² = 27.10, df = 2, p < 0.001, Cramér's V = 0.272).
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basis
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capability object · 4 fields
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capability:computational_analysis
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basis
The computational analysis is owned. The physical bench the paper used is not, so a physical validation cannot be run here.
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This cross-sectional retrospective analysis used publicly available, deidentified data from the GEO dataset GSE141910 (National Center for Biotechnology Information, Bethesda, Maryland, United States), comprising left ventricular myocardial tissue samples collected from multiple centers.
basis
The paper names GSE141910 in Gene Expression Omnibus (GEO) and the accession resolves in the repository. No dataset was downloaded and no licence was read.
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pmid:41322824
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source:pmid:41322824
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PMID 41322824 full text
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data:geo:GSE141910
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GEO GSE141910
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Group differences were assessed using χ² tests for categorical variables (or Fisher's exact test when expected cell counts were <5) and independent t-tests or one-way analysis of variance with Tukey's post hoc comparisons for continuous variables.
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Complete file
{"sci_version": "1.2", "schema": "https://corpus.bntrg.co.uk/sci/1.0/sci.schema.json", "id": "pmid:41322824", "kind": "science-record", "revision": 4, "content_hash": "sha256:5a492dd654d2884659fc56549cb4e25a8148ed9a4274bf49c33819e4175bb268", "created_at": "2026-11-01T20:31:20Z", "updated_at": "2026-11-01T22:57:32Z", "generator": {"name": "corpus-assay-engine", "run_id": "reading-sci-2026-11-01"}, "paper": {"state": "complete", "title": "Racial, Sex, and Age Disparities in Cardiomyopathy Etiology: A Social Determinant Analysis of 366 Cardiac Patients.", "doi": "10.7759/cureus.95664", "pmid": "41322824", "authors": ["Kiki J Estes-Schmalzl", "Amy J Marcano-Reik", "Kristin Lefebvre"], "journal": "Cureus", "year": 2025, "abstract": "BACKGROUND: Inequities in heart failure persist across race, sex, and age, but etiology-specific patterns in cardiomyopathies remain underexplored. We examined disparities across cardiomyopathy etiologies using a social determinants of health (SDoH) lens.\nMETHODS: We analyzed 366 left ventricular tissue samples from the GEO dataset GSE141910, focusing on cardiomyopathy subtypes: dilated cardiomyopathy (DCM), hypertrophic cardiomyopathy (HCM), peripartum cardiomyopathy (PPCM), and nonfailing controls. Demographics included race (African American, Caucasian), sex, and age. We compared distributions using χ² or Fisher's exact tests and assessed age differences with t-tests/analysis of variance.\nRESULTS: African Americans showed a 1.69-fold higher prevalence of DCM vs. Caucasians (62.1%, n = 77 vs. 36.8%, n = 89; χ² = 27.101, df = 2, p < 0.001, Cramér's V = 0.272) and presented 5.9 years earlier (48.9 ± 12.9 years, n = 77 vs. 54.8 ± 7.1 years, n = 89; p < 0.001, Cohen's d = -0.572). HCM was 13.8-fold more common in Caucasians (11.2%, n = 27 vs. 0.8%, n = 1; Fisher's exact p < 0.001). PPCM occurred exclusively in women and was nearly twofold more frequent among African Americans (62.5%, n = 5 of 8 PPCM cases), who also presented younger than Caucasians (29.5 years, n = 2 vs. 37.2 years, n = 4). Male sex was associated with higher DCM prevalence (51.5%, n = 100 vs. 38.4%, n = 66; χ² = 13.845, df = 3, p = 0.016, Cramér's V = 0.194) and predominated in HCM (60.7%, n = 17). Intersectional analyses revealed disproportionate burden among younger African Americans; among DCM patients <45 years, 71.4% (n = 15 of 21) were African Americans.\nCONCLUSIONS: Cardiomyopathy etiology is associated with systematic demographic patterns. African Americans are more likely to experience earlier onset and greater DCM burden, while Caucasians exhibit markedly higher HCM prevalence. Male sex is disproportionately represented in DCM and HCM. These findings are consistent with SDoH-driven inequities and underscore the need for earlier detection, equity-centered prevention, and improved access to specialized diagnostics and therapies.", "claims": [{"id": "claim-method", "statement": "Group differences were assessed using χ² tests for categorical variables (or Fisher's exact test when expected cell counts were <5) and independent t-tests or one-way analysis of variance with Tukey's post hoc comparisons for continuous variables.", "kind": "methodological", "target": null, "evidence": [{"asset": "source:pmid:41322824", "locator": "sections[2] \"Materials and methods\" paragraph 17", "quote": "Group differences were assessed using χ² tests for categorical variables (or Fisher's exact test when expected cell counts were <5) and independent t-tests or one-way analysis of variance with Tukey's post hoc comparisons for continuous variables."}], "state": "complete"}, {"id": "claim-data-access", "statement": "This cross-sectional retrospective analysis used publicly available, deidentified data from the GEO dataset GSE141910 (National Center for Biotechnology Information, Bethesda, Maryland, United States), comprising left ventricular myocardial tissue samples collected from multiple centers.", "kind": "methodological", "target": null, "evidence": [{"asset": "source:pmid:41322824", "locator": "sections[2] \"Materials and methods\" paragraph 3", "quote": "This cross-sectional retrospective analysis used publicly available, deidentified data from the GEO dataset GSE141910 (National Center for Biotechnology Information, Bethesda, Maryland, United States), comprising left ventricular myocardial tissue samples collected from multiple centers."}], "state": "complete"}, {"id": "claim-target-result", "statement": "Etiology distributions differed significantly by race (χ² = 27.10, df = 2, p < 0.001, Cramér's V = 0.272).", "kind": "quantitative", "target": {"value": 0.001, "unit": "p-value", "tolerance": null, "source": "Etiology distributions differed significantly by race (χ² = 27.10, df = 2, p < 0.001, Cramér's V = 0.272)."}, "evidence": [{"asset": "source:pmid:41322824", "locator": "sections[3] \"Results\" paragraph 4", "quote": "Etiology distributions differed significantly by race (χ² = 27.10, df = 2, p < 0.001, Cramér's V = 0.272)."}], "state": "complete"}], "gaps": []}, "experiment": {"state": "complete", "objective": "Etiology distributions differed significantly by race (χ² = 27.10, df = 2, p < 0.001, Cramér's V = 0.272).", "steps": [{"id": "read_published_estimate", "order": 1, "name": "Read the published estimate from the source", "kind": "other", "state": "complete", "blocked_on": null, "description": "The claim, method and evidence span published with the source article.", "duration_hours": null, "parameters": {}, "inputs": ["source:pmid:41322824"], "outputs": ["the published estimate and its evidence"], "instruments": [], "reagents": []}, {"id": "obtain_source_data", "order": 2, "name": "Obtain the source data from the named repository", "kind": "data-preparation", "state": "complete", "blocked_on": null, "description": "The GEO series accession resolves and its sample accessions are listed. This lane did not download the dataset or read its licence.", "duration_hours": null, "parameters": {}, "inputs": ["data:geo:GSE141910"], "outputs": ["the source data with its repository provenance"], "instruments": [], "reagents": []}, {"id": "run_analysis", "order": 3, "name": "Run the published analysis", "kind": "analysis", "state": "complete", "blocked_on": null, "description": "Apply the paper's statistical method to the resolved series and compare the result with the published target.", "duration_hours": null, "parameters": {}, "inputs": ["data:geo:GSE141910"], "outputs": ["the replicated result and its comparison"], "instruments": [], "reagents": []}], "materials": [], "instruments": [], "reagents": [], "conditions": {}, "gaps": []}, "data": {"state": "partial", "assets": [{"id": "source:pmid:41322824", "role": "manuscript", "format": "xml", "media_type": "application/xml", "uri": "https://doi.org/10.7759/cureus.95664", "sha256": 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