Prognosis for patients with apical hypertrophic cardiomyopathy: A multicenter cohort study based on propensity score matching

Background: Apical hypertrophic cardiomyopathy (AHCM) is a subtype of HCM, and few studies on the prognosis in AHCM are available.Aims: This study aimed to explore the clinical prognosis for AHCM and non-AHCM patients through clinical data based on propensity score matching (PSM) in a large cohort of Chinese HCM patients.Methods: The cohort study included 2268 HCM patients, 226 AHCM and 2042 non-AHCM patients from 13 tertiary hospitals, who were treated between 1996 and 2021. Fifteen demographic and clinical variables of 226 AHCM patients and 2042 non-AHCM patients were matched using 1:2 PSM. A Cox proportional hazard regression model was constructed to assess the effect of AHCM on mortality.Results: During a median follow-up of 5.1 (2.4–8.4) years, 353 (15.6%) of the 2268 HCM patients died, of whom 205 died due to cardiovascular mortality/cardiac transplantation and 94 experienced sudden cardiac death (SCD). In the matched cohort, the ACHM patients had lower rates of all-cause mortality (P = 0.003), cardiovascular mortality/cardiac transplantation (P = 0.03), and SCD (P = 0.02) than the non-AHCM patients. Furthermore, the Cox proportional hazard regression model showed that AHCM was an independent prognostic predictor of all-cause HCM mortality (P = 0.004) and a univariable prognostic predictor of cardiovascular mortality/cardiac transplantation (P = 0.03) and for SCD (P = 0.03). However, AHCM was not significant in multivariable Cox regression models in relation to cardiovascular mortality/cardiac transplantation and SCD.Conclusion: AHCM had a favorable prognosis both before and after matching, with lower all-cause mortality, cardiovascular mortality/cardiac transplantation, and SCD than non-AHCM

Multi-Scale Measurement of Regional Inequality in Mainland China during 2005–2010 Using DMSP/OLS Night Light Imagery and Population Density Grid Data

This study used the Night Light Development Index (NLDI) to measure the regional inequality of public services in Mainland China at multiple scales. The NLDI was extracted based on a Gini Coefficient approach to measure the spatial differences of population distribution and night light distribution. Population data were derived from the dataset of China’s population density grid, and night light data were acquired from satellite imagery. In the multi-scale analysis, we calculated the NLDI for China as a whole, eight economic regions, 31 provincial regions, and 354 prefectural cities for the two years of 2005 and 2010. The results indicate that Southwest China and Northwest China are the regions with the most unequal public services, with NLDI values of 0.7116 and 0.7251 for 2005, respectively, and 0.6678 and 0.6304 for 2010, respectively. In contrast, Northern Coastal China had the lowest NLDI values of 0.4775 and 0.4312 for 2005 and 2010, respectively, indicating that this region had the most equal public services. Also, the regional inequality of Mainland China in terms of NLDI has been reduced from 0.6161 to 0.5743 during 2005–2010. The same pattern was observed from the provincial and prefectural analysis, suggesting that public services in Mainland China became more equal within the five-year period. A regression analysis indicated that provincial and prefectural regions with more public services per capita and higher population density had more equal public services