The Impact of Gender on Outcomes Following Transcatheter Aortic Valve Implantation: True Effect or Bias?
J Heart Valve Dis
; 25(5): 552-556, 2016 09.
Article
em En
| MEDLINE
| ID: mdl-28238236
ABSTRACT
Transcatheter aortic valve implantation (TAVI) is currently the treatment of choice for patients with severe aortic stenosis (AS) who are unsuitable for surgical aortic valve replacement (SAVR), and is an acceptable alternative for those at high and intermediate surgical risk. In published TAVI registries and meta-analyses, whilst women are significantly older they present with fewer comorbidities compared to men (including coronary artery disease, peripheral vascular disease, diabetes and chronic obstructive pulmonary disease). In response to chronic pressure overload from AS, women have been shown to develop greater levels of left ventricular hypertrophy than men, as well as having a greater preservation of LV ejection fraction (LVEF) and less fibrosis. Following aortic valve replacement, women have been shown to have a faster regression of myocardial hypertrophy, with a significant improvement in LVEF. Following TAVI, female gender seems to be associated with a significantly lower one-year mortality. In the current viewpoint, it is discussed whether these findings reflect a true differential treatment response to TAVI among women, or simply the higher comorbidity burden among males undergoing TAVI.
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Base de dados:
MEDLINE
Assunto principal:
Estenose da Valva Aórtica
/
Substituição da Valva Aórtica Transcateter
Tipo de estudo:
Etiology_studies
/
Risk_factors_studies
Limite:
Aged80
/
Humans
/
Male
Idioma:
En
Revista:
J Heart Valve Dis
Assunto da revista:
CARDIOLOGIA
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
Reino Unido