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Sex differences in left ventricular systolic function in severe aortic stenosis
Session:
SESSÃO DE POSTERS 16 - DIAGNÓSTICO E PROGNÓSTICO NA ESTENOSE AÓRTICA
Speaker:
António Afonso Angélico Gonçalves
Congress:
CPC 2025
Topic:
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Theme:
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Subtheme:
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Session Type:
Cartazes
FP Number:
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Authors:
António Afonso Angélico Gonçalves; Rafael Silva Teixeira; Inês Arrobas Rodrigues; Marta Catarina Almeida; André Lobo; Marta Fernandes Leite; Ana Inês Neves; Fábio Sousa Nunes; Ricardo Fontes Carvalho
Abstract
<p><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-size:10.0pt"><span style="background-color:white"><span style="font-family:"Calibri",sans-serif"><span style="color:black">Introduction: </span></span></span></span></strong><span style="font-size:10.0pt"><span style="background-color:white"><span style="font-family:"Calibri",sans-serif"><span style="color:black">Sex-related differences in left ventricular (LV) remodeling in response to an increased pressure overload imposed by aortic stenosis (AS) may hinder an accurate assessment of LV systolic function.</span></span></span></span><br /> <br /> <span style="font-size:10.0pt"><span style="font-family:"Calibri",sans-serif"><span style="color:black"><strong><span style="background-color:white">Aim:</span></strong><span style="background-color:white"> Our aim was to compare LV systolic function between genders in patients with severe AS and preserved LV ejection fraction (LVEF).</span><br /> <br /> <strong><span style="background-color:white">Methods:</span></strong><span style="background-color:white"> Patients with a first diagnosis of severe AS and preserved LVEF were retrospectively identified. Propensity score matching (1:1 ratio) was employed based on aortic peak velocity (APV), age, cardiovascular risk factors (diabetes, obesity, arterial hypertension, dyslipidemia, smoking), history of coronary artery disease and atrial fibrillation (AF). LV morphology and systolic function (LVEF and global longitudinal strain [GLS]) were compared between genders. <br /> <br /> <strong>Results: </strong>A total of 288 patients were included, with 144 in each gender group, matched for AS severity (mean APV of 4.4 ± 0.3 m/s), age (mean age of 77 ± 9 years), documented CAD (22%), AF (26%) and comorbidities. Women were more likely to have severe LV hypertrophy based on indexed LV mass (51% vs 35%; p=0.01), despite similar prevalence of LV dilation (19% vs 17%; p=0.76) and relative wall thickness (0.49 ± 0.10 vs 0.5 ± 0.09; p =0.77). However, absolute wall thickness was higher in males (mean posterior wall thickness of 13.0 ± 1.6 vs 11.6 ± 1.8 mm; p=0.001). Despite similar LVEF (59 ± 5%; vs 61 ± 5%; p=0.06), men displayed lower GLS (-20.2 ± 7.3 % vs -22.0 ± 8.0%; p=0.01). <br /> <br /> <strong>Conclusion:</strong> The findings from this study highlight significant gender differences in LV remodeling and systolic function among patients with severe AS and preserved LVEF. The observation that men have lower GLS despite similar LVEF values suggests that conventional measures like LVEF might not fully capture the nuances of systolic function in the context of severe AS, particularly with LV thickened walls.</span></span></span></span></span></span></p>
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