Sex-Related Factors in Valvular Heart Disease: JACC Focus Seminar 5/7

Area of Science:

• Cardiology
• Sex-Based Medicine
• Valvular Heart Disease

Background:

• Valvular heart disease (VHD) exhibits numerous sex-based differences in pathophysiology, progression, and compensation.
• These differences extend to comorbidities, assessment of disease severity, hemodynamic evaluation, and intervention timing.
• While aortic valve disease shows some understood sex differences, significant knowledge gaps persist for other valve conditions.

Purpose of the Study:

• To review and synthesize the current understanding of sex-based differences across the spectrum of valvular heart disease.
• To highlight existing knowledge gaps and emphasize the need for sex-specific research in VHD.
• To underscore the potential for improved disease recognition, treatment strategies, and patient outcomes through sex-specific approaches.

Main Methods:

• Comprehensive literature review focusing on sex differences in VHD.
• Analysis of studies examining pathophysiology, clinical presentation, diagnostic assessment, and therapeutic outcomes in VHD stratified by sex.
• Synthesis of findings related to aortic valve disease and other valvular pathologies.

Main Results:

• Sex influences VHD pathophysiology, disease progression, and the body's compensatory mechanisms.
• Differences are noted in the prevalence, presentation, and outcomes of surgical and transcatheter therapies for VHD.
• Sex-specific variations exist in cardiovascular and noncardiovascular comorbidities associated with VHD.

Conclusions:

• Defining and understanding sex-specific responses in VHD is crucial for advancing cardiovascular medicine.
• Tailoring diagnostic and therapeutic strategies based on sex can potentially optimize management and improve outcomes for patients with VHD.
• Further research is warranted to fully elucidate and address sex-based disparities in valvular heart disease.