Regression of Myocardial Hypertrophy After Aortic Valve Replacement

Petrov, George; Regitz‐Zagrosek, Vera; Lehmkuhl, Elke; Krabatsch, Thomas; Dunkel, Anne; Dandel, Michael; Dworatzek, Elke; Mahmoodzadeh, Shokoufeh; Schubert, Carola; Becher, Eva; Hampl, H.; Hetzer, Roland

doi:10.1161/circulationaha.109.927764

Cited by 211 publications

(172 citation statements)

References 26 publications

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“…So, the greater absolute LV mass regression seen in men was a result of the fact that men have more LV mass at baseline than their female counterparts, rather than a sex-related difference per se. Stangl et al found a better LVEF at baseline and a more favourable LV remodeling response in women upon serial echocardiography following TAVR, but their female population had higher pre-TAVR aortic valve gradients than men, which may explain the greater degree of mass regression seen 13 .In an echocardiographically based study of 92 patients undergoing SAVR for isolated AS, Petrov et al 14 found a similar LVMi at baseline in men and women, but a greater degree of LVM regression in women after SAVR. This study was based on measurements taken only 3 days post-SAVR.…”

Section: Discussionmentioning

confidence: 99%

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Sex-related differences in left ventricular remodeling in severe aortic stenosis and reverse remodeling after aortic valve replacement: A cardiovascular magnetic resonance study

Dobson

Fairbairn

Musa

et al. 2016

American Heart Journal

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Section: Discussionmentioning

confidence: 99%

“…suggest that men and women remodel differently to the pressure overload of AS 11,12 and may also reverse remodel differently following AVR 13,14 . CMR imaging is the reference standard for LV mass and volume quantitation, with low intra-observer and inter-study variability.…”

Section: Fibrosis (Mf) May Be Implicated Echocardiographic and Cardimentioning

confidence: 99%

Sex-related differences in left ventricular remodeling in severe aortic stenosis and reverse remodeling after aortic valve replacement: A cardiovascular magnetic resonance study

Dobson

Fairbairn

Musa

et al. 2016

American Heart Journal

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“…27 Our own investigations showed increased levels of collagens I and III, as well as matrix metalloproteinase (MMP) expression, in a cohort of predominantly male patients undergoing aortic valve surgery, 28,29 and greater upregulation of matrix-related genes in men than in women. 30 Relief of mechanical obstruction by aortic valve replacement led to hemodynamic improvement and a substantial decrease in LV mass in both sexes, but it occurred faster in women than in men. 30 Gene expression profiling in end-stage failing human hearts has revealed similar sex differences as found in animals with HF: less downregulation of energy metabolism in female hearts and more matrix induction in male hearts.…”

Section: Human Hearts: Sex Differences In Pathological Mhmentioning

confidence: 98%

“…30 Relief of mechanical obstruction by aortic valve replacement led to hemodynamic improvement and a substantial decrease in LV mass in both sexes, but it occurred faster in women than in men. 30 Gene expression profiling in end-stage failing human hearts has revealed similar sex differences as found in animals with HF: less downregulation of energy metabolism in female hearts and more matrix induction in male hearts. 31 …”

Section: Human Hearts: Sex Differences In Pathological Mhmentioning

confidence: 98%

Sex and Gender Differences in Myocardial Hypertrophy and Heart Failure

Regitz‐Zagrosek

Oertelt‐Prigione

Seeland

et al. 2010

Circ J

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166

103

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EpidemiologyHeart failure (HF) is one of the leading hospital discharge diagnoses in the modern world and has enormous implications with respect to cardiovascular mortality and morbidity, to individual quality of life experiences and societal resource utilization. The number of patients with HF is continuously increasing. Approximately 10% of 70-year-olds are affected, with an increasing prevalence after that age. HF patients have a life expectancy of approximately 5 years, similar to patients with malignant disease. Women with HF are older than their male counterparts and more likely to exhibit a non-ischemic cause of the disease. 1 The population-based Framingham study suggests that the prognosis in women is significantly better than in men after the onset of HF. 2 However, despite the higher mortality in men, given the overall longer lifespan of women, total numbers of HF deaths are higher in women. The incidence of HF increases dramatically in the female population over 55 years, further compensating the sex differences in mortality. This also appears to account for the stronger correlation between age and mortality observed in women. In fact, in men the NYHA class at baseline is the strongest predictor of mortality, whereas in women it is age. African-Americans might have a higher incidence of HF than Caucasians, with men affected more frequently than females.Major risk factors in both sexes are: age, presence of diabetes, anemia, elevated blood pressure, presence of AF, myocardial hypertrophy (MH) and prior myocardial infarction. Distribution of risk factors differs between the sexes. Women more frequently exhibit hypertension 1,3 and diabetes mellitus. 1,3 Hypertension contributes to the population attributable risk for HF in women to a greater extent than in men. 4 Obesity, diabetes, and impaired glucose carry a greater risk in women and inhibit or impair myocardial metabolism more severely in women than in men. 5-7 Men are more likely to suffer from preexisting coronary heart disease 1,8 and dilated cardiomyopathy (DCM). In the Euro HF survey, systolic HF was found predominantly in men whereas women presented with HF with preserved ejection fraction (EF) or diastolic HF. 9-11 Both systolic and diastolic HF carry a poor prognosis, with astonishingly small differences. 12 MH is a major risk factor for HF and is a negative prognostic sign in itself. Interestingly, women are better protected against the development of MH than men. However, even though MH appears later in women than it does in men at a given hemodynamic load, once established, it is more malign in women. 13 Left ventricular (LV) mass has been presented as the strongest independent mortality predictor in females. Sex and Gender Differences in Myocardial Hypertrophyand Heart Failure Vera Regitz-Zagrosek, MD; Sabine Oertelt-Prigione, MD; Ute Seeland, MD; Roland Hetzer, MDHeart failure (HF) is a leading cause of cardiovascular mortality and morbidity in the Western world. It affects men at younger age than women. Women have more frequently diast...

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“…39,40 Accordingly, mRNA for collagen I, collagen III, matrix metalloproteinase 2, and matrix metalloproteinase 9 was significantly higher in men than in women with AS ( Figure 4A). 41 Collagen gene expression was closely correlated with LVM ( Figure 4B), suggesting that both mechanisms, fibrosis and MH, are closely interrelated. established model of PO in the mouse.…”

Section: Sex Differences In Human Po and Hfmentioning

confidence: 86%