Impact of gender on three-month outcome and left ventricular remodeling after transfemoral transcatheter aortic valve implantation.
Transarterial aortic valve implantation (TAVI) is a promising method for the treatment of high-risk patients with aortic stenosis. Because gender differences are known in aortic stenosis, the aim of this study was to compare procedural and short-term outcomes, left ventricular remodeling, and inflammatory status after TAVI in men and women. One hundred consecutive patients (42 men, 58 women) who underwent transfemoral TAVI (CoreValve in 83%, SAPIEN in 17%) were prospectively analyzed. Aortic stenosis severity was higher in women (mean valve area 0.7 ± 0.3 vs 0.8 ± 0.2 cm(2)). Women had better ejection fractions, smaller end-diastolic and end-systolic diameters, and more concentric hypertrophy at baseline. There were no differences in device success rate (99%), 30-day total mortality (2.4% in men, 3.4% in women), stroke (2.4% in men, 1.7% in women), or pacemaker rate (26.2% in men, 15.5% in women). Periprocedural complications and 3-month outcome were not different between the genders. After TAVI, regression of hypertrophy occurred in men and women, but improvement of the ejection fraction was significant only in women. N-terminal pro-B-type natriuretic peptide decreased to similar levels in the 2 genders. C-reactive protein and interleukin-6, elevated at baseline more in men than in women, decreased after TAVI and normalized at 3 months only in women. In conclusion, women clinically benefit from TAVI to a degree similar to that of men. However, there are gender differences involving the recovery response of the left ventricle after TAVI.
Medizinische Klinik mit Schwerpunkt Kardiologie und Angiologie, Charité Campus Mitte, Universitätsmedizin Berlin, Germany.
Verena
V
Stangl
Gerd
G
Baldenhofer
Fabian
F
Knebel
Kun
K
Zhang
Wasiem
W
Sanad
Sebastian
S
Spethmann
Herko
H
Grubitzsch
Michael
M
Sander
Klaus-Dieter
KD
Wernecke
Gert
G
Baumann
Karl
K
Stangl
Michael
M
Laule
D000368:Aged; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000401:mortality / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D006328:Cardiac Catheterization; D004452:Echocardiography; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D012307:Risk Factors; D012737:Sex Factors; D015996:Survival Rate; D016896:Treatment Outcome; D020257:Ventricular Remodeling