Gender Difference in Ventricular Response to Aortic Stenosis: Insight from Cardiovascular Magnetic Resonance

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2015 Mar 27

PMID 25811358

Citations 6

Authors

Joo Myung Lee

Sung-Ji Park

Seung-Pyo Lee

Eunah Park

Sung-A Chang

Hyung-Kwan Kim

Whal Lee

Yong-Jin Kim

Sang-Chol Lee

Seung Woo Park

Dae-Won Sohn

Yeon Hyeon Choe

Affiliations

Soon will be listed here.

Abstract

Background: Although left ventricular hypertrophy (LVH) and remodeling is associated with cardiac mortality and morbidity, little is known about the impact of gender on the ventricular response in aortic stenosis (AS) patients. This study aimed to analyze the differential effect of gender on ventricular remodeling in moderate to severe AS patients.

Methods And Results: A total of 118 consecutive patients (67±9 years; 63 males) with moderate or severe AS (severe 81.4%) underwent transthoracic echocardiography and cardiovascular magnetic resonance (CMR) within a 1-month period in this two-center prospective registry. The pattern of LV remodeling was assessed using the LV mass index (LVMI) and LV remodeling index (LVRI; LV mass/LV end-diastolic volume) by CMR. Although there were no differences in AS severity parameters nor baseline characteristics between genders, males showed a significantly higher LVMI (102.6±29.1 g/m2 vs. 86.1±29.2 g/m2, p=0.003) and LVRI (1.1±0.2 vs. 1.0±0.3, p=0.018), regardless of AS severity. The LVMI was significantly associated with aortic valve area (AVA) index and valvuloarterial impedance in females, whereas it was not in males, resulting in significant interaction between genders (PInteraction=0.007/0.014 for AVA index/valvuloarterial impedance, respectively). Similarly, the LVRI also showed a significantly different association between male and female subjects with the change in AS severity parameters (PInteraction=0.033/<0.001/0.029 for AVA index/transaortic mean pressure gradient/valvuloarterial impedance, respectively).

Conclusion: Males are associated with greater degree of LVH and higher LVRI compared to females at moderate to severe AS. However, females showed a more exaggerated LV remodeling response, with increased severity of AS and hemodynamic loads, than males.

Citing Articles

Sex-Specific Association of Myocardial Fibrosis With Mortality in Patients With Aortic Stenosis.

Kwak S, Singh A, Everett R, Treibel T, Lim J, Won S JAMA Cardiol. 2025; .

PMID: 39969863 PMC: 11840686. DOI: 10.1001/jamacardio.2024.5593.

Sex Differences in Aortic Stenosis: From the Pathophysiology to the Intervention, Current Challenges, and Future Perspectives.

Springhetti P, Abdoun K, Clavel M J Clin Med. 2024; 13(14).

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Sex and regional differences in myocardial plasticity in aortic stenosis are revealed by 3D model machine learning.

Bhuva A, Treibel T, de Marvao A, Biffi C, Dawes T, Doumou G Eur Heart J Cardiovasc Imaging. 2019; 21(4):417-427.

PMID: 31280289 PMC: 7100908. DOI: 10.1093/ehjci/jez166.

Aortic valvular imaging with cardiovascular magnetic resonance: seeking for comprehensiveness.

De Rubeis G, Galea N, Ceravolo I, Dacquino G, Carbone I, Catalano C Br J Radiol. 2018; 92(1101):20170868.

PMID: 30277407 PMC: 6732913. DOI: 10.1259/bjr.20170868.

Sex-Specific Considerations in Women with Aortic Stenosis and Outcomes After Transcatheter Aortic Valve Replacement.

Mihos C, Klassen S, Yucel E Curr Treat Options Cardiovasc Med. 2018; 20(7):52.

PMID: 29923126 DOI: 10.1007/s11936-018-0651-x.

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