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Gender difference in ventricular response to aortic stenosis: insight from cardiovascular magnetic resonance.


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.

SUBMITTER: Lee JM 

PROVIDER: S-EPMC4374835 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

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Publications

Gender difference in ventricular response to aortic stenosis: insight from cardiovascular magnetic resonance.

Lee Joo Myung JM   Park Sung-Ji SJ   Lee Seung-Pyo SP   Park Eunah E   Chang Sung-A SA   Kim Hyung-Kwan HK   Lee Whal W   Kim Yong-Jin YJ   Lee Sang-Chol SC   Park Seung Woo SW   Sohn Dae-Won DW   Choe Yeon Hyeon YH  

PloS one 20150326 3


<h4>Background</h4>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.<h4>Methods and results</h4>A total of 118 consecutive patients (67±9 years; 63 males) with moderate or severe AS (severe 81.4%) underwent tran  ...[more]

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