title: Does gender affect the rates of abnormal exercise stress echocardiography in patients with asymptomatic severe aortic stenosis?
abstract: OBJECTIVE
  Patient gender can affect not only the clinical manifestations of coronary artery disease (CAD) but also the clinician's interpretation of the symptoms and results of exercise stress tests for management decisions. This may be true also for aortic stenosis (AS), given its many shared features with CAD and similar symptom-based management. The study aim was to evaluate the effect of gender on the assessment of severe asymptomatic AS by exercise stress echocardiography (ESE).
  
  
  METHODS
  A total of 160 patients (89 males, 71 females) with severe asymptomatic AS and good left ventricular function underwent ESE for assessment of their clinical status. Of these patients, 133 (83%) were followed up after echocardiography for a mean of 644 +/- 467 days. The findings and outcome were compared between males and females.
  
  
  RESULTS
  No gender-related differences were identified for mean age, baseline and peak exercise heart rates and blood pressures, aortic valve area, and prevalence of CAD. Female patients had a lower exercise capacity (shorter exercise time, lower exercise load), but there were no significant between-group differences in the exercise-related parameters defining AS. In total, 38 women (24%) and 45 men (28%) were treated by aortic valve replacement (p = 0.2) within a similar time range from echocardiography (p = 0.6).
  
  
  CONCLUSIONS
  Asymptomatic women with severe AS have similar rates of abnormal ESE as men, despite limitations in exercise capacity among women compared to men.
authors.affiliation: The Dan Sheingarten Echocardiography Unit and Valvular Clinic, Department of Cardiology, Rabin Medical Center, Beilinson Campus, Petach Tikva, Israel. mvaturi@clalit.org.il
authors.forename: Mordehay
authors.initials: M
authors.lastname: Vaturi
authors.forename: Daniel
authors.initials: D
authors.lastname: Weisenberg
authors.forename: Idit
authors.initials: I
authors.lastname: Yedidya
authors.forename: Yaron
authors.initials: Y
authors.lastname: Shapira
authors.forename: Roman
authors.initials: R
authors.lastname: Nevzorov
authors.forename: Daniel
authors.initials: D
authors.lastname: Monakier
authors.forename: Alex
authors.initials: A
authors.lastname: Sagie
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging*; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery; D058070:Asymptomatic Diseases; D019468:Disease Management; D025401:Echocardiography, Stress / Q000379:methods / Q000706:statistics & numerical data; D005080:Exercise Test / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000706:statistics & numerical data; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D012737:Sex Factors; D013997:Time Factors; D016277:Ventricular Function, Left