Aortic stenosis. Gender influence on left ventricular geometry and function in patients under 70 years of age.

OBJECTIVE: To verify if adaptive left ventricle (LV) characteristics are also present in individuals under 70 years of age with severe aortic stenosis (AS). METHODS: The study comprised 40 consecutive patients under 70 years of age with AS and no associated coronary artery disease, referred for valve surgery. Out of the 40 patients, 22 were men and 18 women, and the mean age was 49.8 +/- 14.3 years. Cardiac symptoms, presence of systemic hypertension (SH), functional class according to the New York Heart Association (NYHA), and valve lesion etiology were considered. LV cavity dimensions, ejection fraction (EF), fractional shortening (FS), mass (MS), and relative diastolic thickness (RDT) were examined by Doppler echocardiography. RESULTS: Fourteen (63.6%) men and 11 (61.6%) women were classified as NYHA class III/IV (p = 0.70). There was no difference in the frequency of angina, syncope or dyspnea between genders. The incidence of SH was greater in women than in men (10 versus 2, p = 0.0044). Women had a smaller LV end-diastolic diameter index (32.1 +/- 6.5 x 36.5 +/- 5.3 mm/m2, p = 0.027), LV end-systolic diameter index (19.9 +/- 5.9 x 26.5 +/- 6.4 mm/m2, p = 0.0022) and LV mass index (MS) (211.4 +/- 71.1 x 270.9 +/- 74.9 g/m2, p = 0.017) when compared with men. EF (66.2 +/- 13.4 x 52.0 +/- 14.6%, p = 0.0032), FS (37.6 +/- 10.7 x 27.9 +/- 9.6%, p = 0.0046) and RDT (0.58 +/- 0.22 x 0.44 +/- 0.09, p = 0.0095) were significantly greater in women than in men. CONCLUSION: It is the patient gender rather than age that influences left ventricular adaptive response to AS.

Myxoma of the mitral valve.

Only rarely do myxomas originate from the mitral valve. This is the report of a 49-year-old woman presenting with congestive heart failure. The diagnosis of an intracardiac tumor involving the anterior cuspid of the mitral valve was made by transesophageal echocardiography. The patient underwent surgery for tumor resection and plasty of the valve was made with reconstruction and preservation of the valve. The diagnosis of myxoma was confirmed by histology. This is the 23rd case of myxoma of the mitral valve reported in the literature.