Key result
Male patients with bicuspid aortic valve presented more often with moderate or severe aortic regurgitation at a young age, whereas female patients had more frequent aortic stenosis regardless of age.
Why the study?
Different distribution of valve dysfunction has been observed across age and sex groups in bicuspid aortic valve, but related differences were not well established.
Observational (n=620)
No
In patients with bicuspid aortic valve, males present more frequently with aortic regurgitation at a younger age, whereas females predominantly present with aortic stenosis regardless of age.
Sex differences in BAV dysfunction may guide monitoring; leaves open effects on progression and outcomes.
Bicuspid aortic valve (BAV) is the most common congenital heart disease. Different distribution of valve dysfunction was found in patients with BAV in different age and sex groups, but related difference was not well established. The aim of our study is to investigate age- and sex-related clinical characteristics differences in patients with BAV.Six hundred twenty patients with BAV who had moderate or severe aortic valve dysfunction were included in the study. Basic clinical data and image data were recorded. Patients were classified into four different age groups: (A: ≤ 50 years old; B: 50-60 years old; C: 60-70 years old; D: > 70 years old). The sex-related clinical difference in different age groups was compared. Association between incidence of aortic valve dysfunction and age was evaluated.Male patients had more frequent aortic regurgitation (AR) in patients younger than 70 years old (A: 52.3% versus 20.0%, P = 0.012; B: 43.2% versus 17.8%, P < 0.001; C: 17.0 versus 2.6%, P = 0.002), whereas female patients were more likely to have aortic stenosis (AS) (A: 75.0% versus 34.1%, P = 0.001; B: 77.8% versus 37.0%, P < 0.001; C: 93.6% versus 69.8%, P < 0.001). Frequency of AR in male patients decreased with age, whereas frequency of AS increased. Trend test showed a significant difference in incidence of aortic valve dysfunction as age increased in male patients (AR, P < 0.001; AS, P < 0.001). No trend was found in female patients.Male patients with BAV present more often with moderate/severe AR at a young age, and the frequency of AR decreases with age. Female patients with BAV had more frequent AS at first presentation regardless of age.
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Ren et al. (2019) conducted an observational in Bicuspid aortic valve with moderate or severe aortic valve dysfunction (n=620). Male sex vs. Female sex was evaluated on Aortic regurgitation in patients ≤ 50 years old (p=0.012). Male patients with bicuspid aortic valve presented more often with moderate or severe aortic regurgitation at a young age, whereas female patients had more frequent aortic stenosis regardless of age.
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