Sex Differences in Left Ventricular Remodeling for Risk Stratification of Patients With Aortic Regurgitation

What are the sex-specific thresholds for left ventricular (LV) remodeling associated with mortality in asymptomatic aortic regurgitation (AR) with preserved ejection fraction?In this cohort study of 808 patients with moderate-severe AR, women had worse survival during medical management, and mortality thresholds were similar for LV end-systolic diameter index (LVESDi; 20 mm/m) but lower for left ventricular end-systolic volume index (LVESVi) in women (40 mL/m) than in men (45 mL/m). Among 323 who underwent surgery, preoperative LVESVi was associated with postoperative mortality, with a significant sex interaction.Lower LVESDi and sex-specific LVESVi thresholds may improve risk stratification in AR.

Corresponding Author: Nina Ajmone Marsan, MD, PhD, Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Albinusdreef 2 2300 RC Leiden, the Netherlands (n.ajmone@lumc.nl).

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