Impact of biological sex on valvular heart disease, interventions, and outcomes

Area of Science:

• Cardiology
• Sex-Based Medicine
• Reproductive Health

Background:

• Valvular heart disease (VHD) is prevalent in older adults (>14% of those >75).
• VHD is linked to significant morbidity (heart failure, arrhythmia) and mortality.
• Emerging evidence reveals important sex-based differences in VHD epidemiology, pathophysiology, presentation, diagnosis, and outcomes.

Purpose of the Study:

• To review sex differences in aortic, mitral, pulmonic, and tricuspid VHD.
• To focus on variations in pathophysiology, clinical presentation, and outcomes between sexes.
• To discuss the implications of pregnancy on VHD pathophysiology and management.

Main Methods:

• Literature review of existing studies on VHD.
• Analysis of sex-based disparities in VHD.
• Examination of pregnancy-related risks and management in VHD patients.

Main Results:

• Females with VHD often face delayed diagnosis and poorer outcomes compared to males.
• Pregnancy exacerbates risks for both mother and fetus in many VHD cases.
• Significant sex differences exist across various types of VHD.

Conclusions:

• Recognizing sex differences in VHD is critical for effective patient care.
• Understanding VHD pathophysiology and management in pregnant females is essential for clinicians.
• Addressing sex-based disparities can improve outcomes for female VHD patients.