Valvular & structural heart disease
Sex Differences in Left Ventricular Remodeling for Risk Stratification of Patients With Aortic Regurgitation
Authors' conclusion
In this study among individuals with moderate-severe AR, similar LVESDi thresholds (20 mm/m2) for both sexes, but lower than currently recommended by guidelines, were independently associated with mortality. In turn, LVESVi thresholds were 40 mL/m2 for women and 45 mL/m2 for men
Study context
- Population
- Patients with moderate-severe aortic regurgitation and preserved LV ejection fraction (LVEF) (≥50%), asymptomatic, 2003–2022323 underwent aortic valve surgery (AVS)
- Participants
- 808 patients
- Exposure
- Women vs men
- Womenn = 320
- Menn = 488reference
- Outcome
- All-cause mortality during medical management and following aortic valve surgery
- Follow-up
- Median (IQR) 7 (4-11) years
Methodological details5 centres (Netherlands, Singapore, Hong Kong, Canada, Romania)
- 5 centres (Netherlands, Singapore, Hong Kong, Canada, Romania)
Main finding
As reported in the abstract
All-cause mortality under medical management · 6 years
Adjusted 6-year survival
P = 0.001
- Deaths under medical management
- 74
Observational data: associations, not effects.
Further findings
Baseline LVESDi
P = 0.77
Baseline LVESVi
P < 0.001
Postoperative mortality by preoperative LV end-systolic volume index (LVESVi) (sex interaction)
| HR (95% CI) | P value | ||
|---|---|---|---|
| Preoperative LVESVi | 1.03 (1.00–1.06) | P = 0.04 | |
| 0.512Hazard ratio (log scale) |
| Outcome | Women | Men | P value |
|---|---|---|---|
| Survival after AVS | 85% | — not stated in the abstract | P = 0.31 |
— not stated in the abstract
- Postoperative mortality by preoperative LVESVi (sex interaction): sex interaction; only preoperative LVESVi associated with mortality
- Postoperative mortality by preoperative LVESVi (sex interaction): interaction P = .04
Original publication
Sex Differences in Left Ventricular Remodeling for Risk Stratification of Patients With Aortic Regurgitation. JAMA Cardiol. Published 1 March 2026. doi:10.
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