Grading of Aortic Stenosis: Is it More Complicated in Women?

Dana Cramariuc; Edda Bahlmann; Eva Gerdts

doi:10.15420/ecr.2022.13

Grading of Aortic Stenosis: Is it More Complicated in Women?

Eur Cardiol. 2022 Nov 1:17:e21. doi: 10.15420/ecr.2022.13. eCollection 2022 Feb.

Authors

Dana Cramariuc^{1

2}, Edda Bahlmann³, Eva Gerdts²

Affiliations

¹ Department of Heart Disease, Haukeland University Hospital Bergen, Norway.
² Department of Clinical Science, University of Bergen Bergen, Norway.
³ Department of Cardiology, Asklepios Kliniken St. Georg Hamburg, Germany.

Abstract

Aortic stenosis (AS) is the most common valvular heart disease and the main indication for valvular replacement in older women. Correct AS grading is mandatory for an adequate selection of patients for both surgical and transcatheter aortic valve replacement. Women and men have different AS severity grades at the same level of aortic valve calcification. Moreover, besides having smaller cardiac volumes, left ventricular outflow tract and aortic size, women have a specific pattern of left ventricular structural and functional remodelling in response to the AS-related chronic pressure overload. Here, the sex-specific cardiac changes in AS that make AS grading more challenging in women, with consequences for the management and outcome of this group of patients, are reviewed.

Keywords: Aortic stenosis; echocardiography; sex differences; stenosis grading; women's health.

Publication types

Review