Mild To Moderate Aortic Stenosis Progression: Sex Differences

2 Aug 2023 • The study included 2,549 patients with native mild to moderate aortic stenosis (AS) and found that males had a higher prevalence of chronic comorbidities such as hyperlipidemia, atrial fibrillation, and coronary artery disease compared to females.

However, there was no difference in all-cause mortality between sexes, regardless of age, disease severity, progression to severe AS, or receipt of aortic valve replacement (AVR).

  • In terms of disease progression, males had a significantly faster progression, with higher increases in mean gradient, maximum transvalvular velocity, and left ventricular end-diastolic diameters compared to females.
  • The study also revealed distinct clinical and echocardiographic differences between males and females. Females had higher left ventricular ejection fraction (LVEF), E/e' (a measure of LV filling pressure), right ventricular systolic pressure, and left ventricular septum thickness over time on follow-up echocardiograms compared to males. Females were more likely to have concentric hypertrophy, a type of left ventricular remodeling in response to chronic pressure overload.

In conclusion, in patients with native mild to moderate AS, males have a higher burden of chronic comorbidities, while males and females exhibit different clinical and echocardiographic profiles of left ventricular remodeling in response to the disease.

Source: ACC | Read full story

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