Age- and Sex-Related Aortic Valve Dysfunction and Aortopathy Difference in Patients with Bicuspid Aortic Valve

Bicuspid aortic valve (BAV) is the most common congenital heart disease. Different distribution of valve dysfunction was found in patients with BAV in different age and sex groups, but related difference was not well established. The aim of our study is to investigate age- and sex-related clinical characteristics differences in patients with BAV.Six hundred twenty patients with BAV who had moderate or severe aortic valve dysfunction were included in the study. Basic clinical data and image data were recorded. Patients were classified into four different age groups: (A: ≤ 50 years old; B: 50-60 years old; C: 60-70 years old; D: > 70 years old). The sex-related clinical difference in different age groups was compared. Association between incidence of aortic valve dysfunction and age was evaluated.Male patients had more frequent aortic regurgitation (AR) in patients younger than 70 years old (A: 52.3% versus 20.0%, P = 0.012; B: 43.2% versus 17.8%, P < 0.001; C: 17.0 versus 2.6%, P = 0.002), whereas female patients were more likely to have aortic stenosis (AS) (A: 75.0% versus 34.1%, P = 0.001; B: 77.8% versus 37.0%, P < 0.001; C: 93.6% versus 69.8%, P < 0.001). Frequency of AR in male patients decreased with age, whereas frequency of AS increased. Trend test showed a significant difference in incidence of aortic valve dysfunction as age increased in male patients (AR, P < 0.001; AS, P < 0.001). No trend was found in female patients.Male patients with BAV present more often with moderate/severe AR at a young age, and the frequency of AR decreases with age. Female patients with BAV had more frequent AS at first presentation regardless of age.