title: Gender difference in ventricular response to aortic stenosis: insight from cardiovascular magnetic resonance.
abstract: BACKGROUND
  Although left ventricular hypertrophy (LVH) and remodeling is associated with cardiac mortality and morbidity, little is known about the impact of gender on the ventricular response in aortic stenosis (AS) patients. This study aimed to analyze the differential effect of gender on ventricular remodeling in moderate to severe AS patients.
  
  
  RESULTS
  A total of 118 consecutive patients (67±9 years; 63 males) with moderate or severe AS (severe 81.4%) underwent transthoracic echocardiography and cardiovascular magnetic resonance (CMR) within a 1-month period in this two-center prospective registry. The pattern of LV remodeling was assessed using the LV mass index (LVMI) and LV remodeling index (LVRI; LV mass/LV end-diastolic volume) by CMR. Although there were no differences in AS severity parameters nor baseline characteristics between genders, males showed a significantly higher LVMI (102.6±29.1 g/m2 vs. 86.1±29.2 g/m2, p=0.003) and LVRI (1.1±0.2 vs. 1.0±0.3, p=0.018), regardless of AS severity. The LVMI was significantly associated with aortic valve area (AVA) index and valvuloarterial impedance in females, whereas it was not in males, resulting in significant interaction between genders (PInteraction=0.007/0.014 for AVA index/valvuloarterial impedance, respectively). Similarly, the LVRI also showed a significantly different association between male and female subjects with the change in AS severity parameters (PInteraction=0.033/<0.001/0.029 for AVA index/transaortic mean pressure gradient/valvuloarterial impedance, respectively).
  
  
  CONCLUSIONS
  Males are associated with greater degree of LVH and higher LVRI compared to females at moderate to severe AS. However, females showed a more exaggerated LV remodeling response, with increased severity of AS and hemodynamic loads, than males.
authors: Cardiovascular Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Department of Internal Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Joo Myung
authors: JM
authors: Lee
authors: Cardiovascular Imaging Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Sung-Ji
authors: SJ
authors: Park
authors: Cardiovascular Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Department of Internal Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Seung-Pyo
authors: SP
authors: Lee
authors: Department of Radiology, Seoul National University Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Eunah
authors: E
authors: Park
authors: Cardiovascular Imaging Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Sung-A
authors: SA
authors: Chang
authors: Cardiovascular Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Department of Internal Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Hyung-Kwan
authors: HK
authors: Kim
authors: Department of Radiology, Seoul National University Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Whal
authors: W
authors: Lee
authors: Cardiovascular Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Department of Internal Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Yong-Jin
authors: YJ
authors: Kim
authors: Cardiovascular Imaging Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Sang-Chol
authors: SC
authors: Lee
authors: Cardiovascular Imaging Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Seung Woo
authors: SW
authors: Park
authors: Cardiovascular Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Department of Internal Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Dae-Won
authors: DW
authors: Sohn
authors: Cardiovascular Imaging Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Yeon Hyeon
authors: YH
authors: Choe
mesh_terms: D000368:Aged; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology*; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles / Q000473:pathology* / Q000503:physiopathology*; D006439:Hemodynamics; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000503:physiopathology; D018810:Magnetic Resonance Angiography / Q000379:methods; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D020257:Ventricular Remodeling