After TAVR, men had more pronounced reverse cardiac remodeling than women, who exhibited a higher prevalence of moderate or severe tricuspid regurgitation at 1 year (21.4% vs 10.3%, P<0.001).
Cohort (n=963)
No
Does reverse cardiac remodeling after TAVR differ between male and female patients with severe aortic stenosis?
Following TAVR, male patients experience more pronounced reverse cardiac remodeling and functional improvement compared to female patients, who have a higher prevalence of residual tricuspid regurgitation.
Abstract Background and Aim Reverse cardiac remodeling following transcatheter aortic valve replacement (TAVR) is associated with significant clinical benefits. This study aimed to analyze sex-related differences in reverse cardiac remodeling in patients with severe aortic stenosis (AS) after TAVR. Methods We conducted a retrospective analysis of a prospective cohort of patients with severe AS who underwent TAVR at a tertiary care center between 2017 and 2023. Echocardiographic anatomical and functional parameters were compared before the procedure and at a 1-year follow-up, with a focus on differences between male and female patients. Results A total of 963 patients were included, of whom 52.1% (n = 502) were female. The mean age was 81.8 years (±5.9), and the mean EuroSCORE II was 4.9 (±6). At 1-year follow-up, both male and female patients showed significant reductions in left ventricular (LV) volumes, LV mass, and left atrial (LA) reservoir strain. However, LV function and LA volumes improved significantly only in male patients. Right ventricular-pulmonary artery (RV-PA) coupling increased in both sexes, but the improvement was less pronounced in female patients. Additionally, moderate or severe mitral (15.6% vs. 20.1%; p = 0.073) and tricuspid regurgitation (10.3% vs. 21.4%; p 0.001) were more prevalent among female patients at follow-up. Conclusions While both male and female patients experienced significant improvements in echocardiographic parameters after TAVR, the response was more pronounced in men. Right ventricular function, assessed by RV-PA coupling, remained superior in men at baseline and follow-up. Female patients had a higher prevalence of concomitant mitral and tricuspid regurgitation post-procedure. These sex-based differences may be influenced by baseline cardiac function, comorbidities, and procedural timing. Further research is needed to determine whether tailored treatment strategies could optimize post-TAVR outcomes, particularly in female patients.Figure1 Figure2
Florez et al. (2025) conducted a cohort in severe aortic stenosis (n=963). Female sex vs. Male sex was evaluated on Reverse cardiac remodeling (echocardiographic anatomical and functional parameters). After TAVR, men had more pronounced reverse cardiac remodeling than women, who exhibited a higher prevalence of moderate or severe tricuspid regurgitation at 1 year (21.4% vs 10.3%, P<0.001).