Sex-Related Factors in Valvular Heart Disease
Open accessAbstract
Numerous sex-based differences are observed across the spectrum of valvular heart disease, starting with pathophysiology and progression of disease, moving on to compensation and comorbidities (both cardiovascular such as coronary artery disease and noncardiovascular such as frailty), assessment of severity and hemodynamics including timing of intervention, and procedural risks/benefits and outcomes. The aortic valve is perhaps best understood with sex differences in both pathologic changes and response to volume and pressure overload, yet large gaps in our understanding still exist. Studies of other valve diseases have focused on differences in prevalence, presentation, and outcomes for surgical or transcatheter therapies. Defining sex-specific responses to valvular heart disease may improve disease recognition, define treatment strategies, and improve outcomes.
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Women have lower AV calcium scores and indexed calcium density values than men for the same hemodynamic severity of AS.
“Even though mineralization/calcification of the leaflets has been long considered the main driver of the development and progression of AS, it is also apparent that women have lower AV calcium scores and indexed calcium density values than men for the same hemodynamic severity of AS8–10.”
From Characterization of Aortic Valve Stenosis by CT Angiography in a Diverse US Cohort (2025) · cites this paper as [9]
The AORTIC STENOSIS section says women have less aortic-valve calcification than men at the same hemodynamic severity, including when measured by CT. It does not report indexed calcium density values, so that more specific part of the claim is unsupported by this copy. (LLM, conf=0.88)
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Self-citationCharacterization of Aortic Valve Stenosis by CT Angiography in a Diverse US Cohort
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“Several publications have reported sex speci fi city in valvular heart disease, 82,83 especially in aortic stenosis 17,84-86 and mitral regurgitation.”
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Timing for Intervention in Aortic Regurgitation
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Timing Surgical Mitral Valve Repair for Primary Mitral Regurgitation
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Does Biological Sex Determine the Natural History and Management of Infective Endocarditis?
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Self-citationSex-Specific Outcomes in Patients With Aortic Stenosis and Reduced Ejection Fraction
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Self-citationLong-Term Outcomes in Aortic Stenosis: Mortality Analysis in a Selected Patient Group
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“Women also tend to have fewer comorbidities compared to men with AS, yet paradoxically face lower five-year survival rates, possibly due to delayed diagnosis or differences in disease progression [11,12].”
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Unveiling sex differences in valvular disease care and outcomes
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A Brief Overview of Sex Differences in Transcatheter Therapeutics in Valvular Heart Disease
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Valvular Heart Diseases in Women: Where Are We Now?
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Self-citationCardiovascular imaging in women
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“6 Moreover, pregnancy is also a key factor, influencing choices in prosthesis selection and management.”
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“Закономерно, у пациентов с недостаточностью ТК (n=403) имел место более высокий уровень расчет-ного СДЛА по данным ЭхоКГ до коррекции порока 30,0 [26,0; 41,5] мм рт.ст., чем у лиц без ВНТК 28,0 [22,0; 35,0] мм рт.ст., p<0,001.”
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“34 35-37 These results highlight the fact that VHD should be a particular focus in women.”
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Sex-Specific Differences in Patient-Centered Outcomes After Transcatheter Aortic Valve Replacement
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Women’s heart and echocardiography
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- Authors
- Hahn, R. T., Clavel, M.-A., Mascherbauer, J., Mick, S. L., Asgar, A. W., & Douglas, P. S.
- Affiliations
- Columbia University Irving Medical Center (US)
- Institut universitaire de cardiologie et de pneumologie de Québec (CA)
- Universitätsklinikum St. Pölten (AT)
- Weill Cornell Medicine (US)
- Montreal Heart Institute (CA)
- Duke University (US)
- Corresponding author
- Hahn, Rebecca T.
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2022-04
- Volume
- 79
- Issue
- 15
- Pages
- 1506-1518
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W4223546407
- Cited by
- 55
- References
- 56
- Citations by year
- 2026: 14 · 2025: 20 · 2024: 9 · 2023: 8 · 2022: 4
- FWCI
- 2.08
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Corpus Université Laval (Université Laval) (submittedVersion)
- Funders
- Edwards Lifesciences
- Abbott Vascular
- Abbott Laboratories
- Medtronic
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Valve Diseases and Treatments
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Sex and Gender in Healthcare
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Aortic Disease and Treatment Approaches
- Keywords
- valvular heart disease, sex differences, aortic valve disease, fluid overload, pressure overload, frailty, transcatheter valve therapy, valve replacement, hemodynamics, disease severity assessment
- MeSH terms
- Aortic Valve, Female, Heart Valve Diseases, Hemodynamics, Humans, Male, Sex Factors, Heart Valve Prosthesis Implantation
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