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Sex-Related Differences in Medically Treated Moderate Aortic Stenosis
Jan Stassen1, Stephan M Pio1, See Hooi Ewe2
1Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
Men with moderate aortic stenosis (AS) have worse survival than women. Male sex is linked to higher mortality, highlighting the need for sex-specific management strategies in moderate AS.
Area of Science:
- Cardiology
- Clinical Medicine
- Sex Differences in Health
Background:
- Moderate aortic stenosis (AS) is associated with poor long-term survival.
- Sex differences in left ventricular (LV) remodeling and outcomes are known in severe AS but not evaluated in moderate AS.
Purpose of the Study:
- To investigate sex differences in LV remodeling and clinical outcomes in patients with moderate AS.
- To determine if male sex is an independent predictor of mortality in moderate AS.
Main Methods:
- Retrospective, multicenter study of 1895 patients with moderate AS (2001-2019).
- Comparison of clinical and echocardiographic parameters between men and women.
- Follow-up for all-cause mortality, censored at aortic valve replacement.
Main Results:
- Women exhibited more concentric hypertrophy and pronounced LV diastolic dysfunction than men.
- Men had significantly higher 3- and 5-year mortality rates (30%, 48%) compared to women (26%, 39%).
- Male sex was independently associated with increased mortality (HR 1.209; p=0.025); LV remodeling also predicted worse outcomes.
Conclusions:
- Distinct LV remodeling patterns exist between sexes in moderate AS.
- Male sex is an independent predictor of worse outcomes in medically treated moderate AS.
- Sex-specific management approaches for moderate AS require further investigation.
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