GENDER-ASSOCIATED DIFFERENCES IN LEFT-VENTRICULAR GEOMETRY IN PATIENTS WITH AORTIC-VALVE DISEASE AND EFFECT OF DISTINCT OVERLOAD SUBSETS

Gender-associated differences may play an important role in the way th e left ventricle adapts to overload. The purpose of this study is to e valuate left ventricular (LV) geometry in patients referred for aortic valve replacement with distinct overload subsets, The echocardiograms of 128 patients with isolated aortic stenosis (n = 44), mixed aortic valvular disease (n = 51), and pure aortic regurgitation (n = 33) befo re aortic valve replacement were evaluated, Women had better LV functi on as measured by ejection fraction (58% vs 52%; p = 0.01) and were sl ightly older (67 vs 62 years, p = 0.11). LV dimensions and volumes ind exes were distinctively smaller in women irrespective of the subgroups analyzed. Men had larger LV mass and LV mass index, but women had hig her LV mass/volume ratio. Gender-related differences in LV mass/volume ratio were most prominent in the aortic stenosis patients (3.1 g/ml f or women vs 2.3 g/ml for men; p = 0.001), tended to decrease in mixed aortic disease (2.3 g/ml for women vs 1.8 g/ml For men; p = 0.01), and were nor present in patients with pure aortic regurgitation (1.7 g/ml for women vs 1.7 g/ml for men; p = 0.83). Multivariate analysis showe d that gender was independently associated with LV mass/volume ratios, after adjusting for the severity of the valvular lesion, age, LV func tion, and concomitant coronary bypass graft surgery. Thus, in a select ed population of patients with severe aortic valvular disease, there w ere significant gender-related differences in LV geometry, mainly in p atients exposed to chronic pressure overload. (C) 1997 by Excerpta Med ica, Inc.