Key result
In patients with bicuspid aortic valve, male gender was associated with a significantly higher rate of preoperative aortic regurgitation ≥2+ compared to females (39.0% vs 12.8%; OR 5.15, p<0.001).
Why the study?
Gender differences in bicuspid aortic valve are not well understood.
Are there gender differences in Sievers types, valvulopathy, aortopathy, and outcomes of aortic valve replacement in patients with bicuspid aortic valve?
Cohort (n=992)
Are there gender differences in Sievers types, valvulopathy, aortopathy, and outcomes of aortic valve replacement in patients with bicuspid aortic valve?
In Chinese patients with bicuspid aortic valve, men develop more severe valvulopathy and aortopathy at a younger age and have worse left ventricular function after aortic valve replacement compared to women.
BACKGROUND: The gender difference of the bicuspid aortic valve (BAV) is not well understood. OBJECTIVES: We evaluated the impact of gender on the Sievers types, valvulopathy, aortopathy, and outcomes of aortic valve replacement (AVR) of BAV patients in a cohort of Chinese patients. METHODS: Among 992 BAV patients without aortic dissection nor congenital heart disease, 658 underwent AVR. The demography, Sievers types, valvulopathy, aortopathy, and outcomes of AVR were compared between genders. RESULTS: Aortic regurgitation (AR ≥ 2+) (39.0% vs. 12.8%, p < .001), aortic root dilation only (3.8% vs. .8%, p = .014), and diffuse dilation (25.3% vs. 4.3%, p < .001) were more common in men, while moderate to severe aortic stenosis (AS) (21.3% vs. 45.7%, p < .001) and ascending dilation only (46.2% vs. 61.2%, p < .001) were more common in women. Men were more prone to develop preoperative AR ≥ 2+ (OR = 5.15, p < .001), moderate to severe AS + AR ≥ 2 + (OR = 2.95, p = .001), and Diffuse aortic dilation (OR = 3.91, p < .001). Sievers types did not have a significant effect on valvular dysfunction. Gender didn't predict early adverse events after AVR (n = 90) (HR = 1.21, p = .44), but male gender predicted a left ventricular ejection fraction <50% after AVR (OR = 3.07, p = .03). CONCLUSIONS: In this BAV series of Chinese patients, gender didn't differ significantly in Sievers types of BAV but showed significant differences in valvulopathy, aortopathy, and LV function after AVR. In addition, the male patients developed more severe conditions at a younger age.
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Li et al. (2022) conducted a cohort in Bicuspid aortic valve (n=992). Male gender vs. Female gender was evaluated on preoperative aortic regurgitation (AR ≥ 2+) (OR 5.15, p=<0.001). In patients with bicuspid aortic valve, male gender was associated with a significantly higher rate of preoperative aortic regurgitation ≥2+ compared to females (39.0% vs 12.8%; OR 5.15, p<0.001).
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