Gender Difference in Ventricular Response to Aortic Stenosis: Insight from Cardiovascular Magnetic Resonance |
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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 |
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Affiliation: | 1. Cardiovascular Center, Sungkyunkwan University School of Medicine, Seoul, Korea.; 2. Department of Internal Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea.; 3. Department of Radiology, Seoul National University Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.; 4. Cardiovascular Imaging Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.; Sapienza University of Rome, ITALY, |
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Abstract: | BackgroundAlthough 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 ResultsA 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±29.1g/m2 vs. 86.1±29.2g/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).ConclusionMales 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. |
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