Left ventricular geometry and function in patients with aortic stenosis: gender differences

• Published in: International journal of cardiology Vol. 71; no. 1; pp. 57 - 61
• Main Authors: Kostkiewicz, Magdalena, Tracz, Wieslawa, Olszowska, Maria, Podolec, Piotr, Drop, Dobromila
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 30-09-1999; Elsevier Science
• Subjects: Aortic stenosis; Aortic Valve Stenosis - complications; Aortic Valve Stenosis - pathology; Aortic Valve Stenosis - physiopathology; Biological and medical sciences; Cardiology. Vascular system; Echocardiography; Endocardial and cardiac valvular diseases; Female; Gender; Heart; Heart Ventricles - diagnostic imaging; Heart Ventricles - pathology; Humans; Hypertrophy, Left Ventricular - classification; Hypertrophy, Left Ventricular - etiology; Left ventricle function; Left ventricular geometry; Male; Medical sciences; Middle Aged; Retrospective Studies; Sex Factors; Stroke Volume; Ultrasonography; Ventricular Remodeling; Aortic stenosis; Left ventricular geometry; Echocardiography; Left ventricle function; Gender; Heart; Human; Prognosis; Cardiac valvular disease; Heart disease; Sex; Cardiovascular disease; Narrowing; Left ventricle performance; Aortic valve; Comparative study; Hypertrophy
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/S0167-5273(99)00114-X

Background: Gender differences in cardiac size have been described in normal and pathological conditions in human and animals. Sex determination of a pattern of hypertrophy as a response to pressure overload has not been extensively evaluated and is still poorly understood in humans.
Methods and results: To investigate the influence of gender in the left ventricle remodelling and preservation of the left ventricle function 195 adults (140 men and 55 women) with isolated aortic stenosis were evaluated. The mean age was 52±11 years for men and 53±13 years for women. All the patients had similar degree of aortic stenosis finally treated with valve replacement, similar clinical status and no signs of coronary artery disease in coronary angiograms. On echocardiography the left ventricle of women had a smaller the end systolic (30.5±7.8 vs. 39.4±11.2,
P<0.001) and the end diastolic (49.4±9 vs. 57.3±11,
P<0.001) chamber size. The female left ventricle generated a higher relative wall thickness (0.65±0.21 vs. 0.52±0.12,
P<0.01), a greater fractional shortening (35.3±8.5 vs. 32.0±9.0,
P<0,01) and a higher ejection fraction (64.4±12.7 vs. 57.5±14.6,
P<0.001). The left ventricle posterior wall thickness and the septal thickness indexes were similar in both groups. There were also significant differences between the two groups in the left ventricle mass index.
Conclusions: Gender has an important influence on the left ventricle adaptation pattern to pressure overload due to aortic stenosis. Women developed a greater degree of left ventricle hypertrophy documented as changes in left ventricle geometry (increased relative wall thickness, left ventricular mass) and left ventricle function (fractional shortening and ejection fraction).