Vertaisarvioitu alkuperäisartikkeli tai data-artikkeli tieteellisessä aikakauslehdessä (A1)

Sex-Related Differences in Medically Treated Moderate Aortic Stenosis




Julkaisun tekijät: Stassen Jan, Pio Stephan M., Ewe See Hooi, Amanullah Mohammed R., Hirasawa Kensuke, Butcher Steele C., Singh Gurpreet K., Sin Kenny Y.K., Ding Zee P., Chew Nicholas W.S., Sia Ching-Hui, Kong William K.F., Poh Kian Keong, Cohen David J., Généreux Philippe, Leon Martin B., Marsan Nina Ajmone, Delgado Victoria, Bax Jeroen J.

Kustantaja: ELSEVIER SCIENCE INC

Julkaisuvuosi: 2022

Journal: Structural Heart

Tietokannassa oleva lehden nimi: STRUCTURAL HEART-THE JOURNAL OF THE HEART TEAM

Lehden akronyymi: STRUCT HEART

Volyymi: 6

Julkaisunumero: 3

Sivujen määrä: 8

ISSN: 2474-8706

eISSN: 2474-8714

DOI: http://dx.doi.org/10.1016/j.shj.2022.100042

Verkko-osoite: https://www.sciencedirect.com/science/article/pii/S2474870622018085

Rinnakkaistallenteen osoite: https://research.utu.fi/converis/portal/detail/Publication/176223989


Tiivistelmä

Background
Recent data showed poor long-term survival in patients with moderate AS. Although sex differences in left ventricular (LV) remodeling and outcome are well described in severe AS, it has not been evaluated in moderate AS.

Methods
In this retrospective, multicenter study, patients with a first diagnosis of moderate AS diagnosed between 2001 and 2019 were identified. Clinical and echocardiographic parameters were recorded at baseline and compared between men and women. Patients were followed up for the primary endpoint of all-cause mortality with censoring at the time of aortic valve replacement.

Results
A total of 1895 patients with moderate AS (age 73 ± 10 years, 52% male) were included. Women showed more concentric hypertrophy and had more pronounced LV diastolic dysfunction than men. During a median follow-up of 34 (13-60) months, 682 (36%) deaths occurred. Men showed significantly higher mortality rates at 3- and 5-year follow-up (30% and 48%, respectively) than women (26% and 39%, respectively) (p = 0.011). On multivariable analysis, male sex remained independently associated with mortality (hazard ratio 1.209; 95% CI: 1.024-1.428; p = 0.025). LV remodeling (according to LV mass index) was associated with worse outcomes (hazard ratio 1.003; CI: 1.001-1.005; p = 0.006), but no association was observed between the interaction of LV mass index and sex with outcomes.

Conclusions
LV remodeling patterns are different between men and women having moderate AS. Male sex is associated with worse outcomes in patients with medically treated moderate AS. Further studies investigating the management of moderate AS in a sex-specific manner are needed.


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Last updated on 2022-22-09 at 15:23