Abstract 14897: Gender Differences and Flow Category Effects on Left Ventricular Remodelling in Patients With Severe Aortic Stenosis and Preserved Left Ventricular Ejection Fraction
Introduction: Gender differences in the pattern of adaptive left ventricular (LV) hypertrophy to pressure overload from aortic stenosis (AS) has previously been identified. Differential effects in low versus normal-flow AS have not been investigated. We aim to examine effect of gender on LV remodeling in patients with low flow (LF) compared with normal flow (NF) AS.
Methods: We studied 486 patients over a 12-year period with severe AS (valve area <1cm2) and preserved left ventricular ejection fraction (LVEF ≥50%). They were divided into LF (stroke volume index <35 ml/m2) and NF. Parameters were compared between genders.
Results: There were 287 (59%) females, 93 (32%) were LF. In both genders, LV was smaller with lower mass index and higher relative wall thickness in the LF group. In the NF group, although aortic valve area index (AVAI) was larger in the females, mean gradient, peak velocity, degree of LV hypertrophy and LVEF were similar between the genders. LV volumes and LA dimensions were significantly smaller and larger in females respectively. Conversely in the LF group, all parameters indicate consistently more severe AS in males (Table). LVEF was lower and LV mass indexed to body surface area was higher in males (Table). The gender differences of end diastolic LV volume and LA dimension were similar between the categories. Valvuloarterial impedance was elevated and systemic compliance was reduced in the LF group in both genders compared to the NF group (Table).
Conclusions: In patients with severe AS and preserved LVEF, LV appears smaller with lower mass and higher remodeling in LF compared to NF. Greater gender disparity in LV remodeling is documented in LF. Further studies on the prognostic significance are warranted.
Author Disclosures: W. Lin: None. I. Kuntjoro: None. E. Tay: None. W. Kong: None. T. Yeo: None. K. Poh: None.
- © 2014 by American Heart Association, Inc.