Sex-Specific Functional Status Decline and Outcomes in Mild-to-Moderate Aortic Stenosis: Results From the PROGRESSA Study.

Background

Little is known about the effect of sex on functional status decline in aortic valve stenosis (AS) patients.

Objectives

The purpose of this study was to examine the changes in functional status according to sex in patients with mild-to-moderate AS and its association with the composite of death or aortic valve replacement (AVR).

Methods

We included patients with mild-to-moderate AS prospectively recruited in the PROGRESSA (Metabolic Determinants of the Progression of Aortic Stenosis) study (NCT01679431). Functional status was assessed using the New York Heart Association classification and the Duke Activity Status Index (DASI).

Results

A total of 244 patients (mean age 64 ± 14 years, 29% women) were included. The mean follow-up was 4.3 ± 2.4 years. Women with intermediate-to-fast AS progression rate (median change in peak aortic jet velocity ≥0.11 m/s/year) had significantly faster decline in DASI score compared to men with similar progression rate (

Conclusions

In patients with mild-to-moderate AS at baseline, intermediate-to-fast progression rate of AS was associated with a more rapid decline of functional status during follow-up, particularly in women. Functional status decline during follow-up was strongly associated with the incidence of death or AVR, with comparable effect in both women and men.

Informations de copyright

© 2024 The Authors.

Déclaration de conflit d'intérêts

This work was supported by grants # FDN-143225 and MOP-114997 from the 10.13039/501100000024Canadian Institutes of Health Research (CIHR), Ottawa, Ontario, Canada, and a grant from the Foundation of the Québec Heart and Lung Institute. Dr Clavel holds the Canada Research Chair on Women’s Valvular Heart Health and Dr Pibarot the Canada Research Chair in Valvular Heart Diseases from CIHR, Ottawa, Ontario, Canada. Dr Capoulade holds a “Connect Talent” research chair from Region Pays de la Loire and Nantes Metropole (France). Dr Clavel has received funding from 10.13039/100006520Edwards Lifesciences for CT core laboratory analyses and research grant from 10.13039/100004374Medtronic in the field of surgical aortic valve bioprosthesis with no direct personal compensation. Dr Pibarot has received funding from 10.13039/100006520Edwards Lifesciences and 10.13039/100004374Medtronic for echocardiography core laboratory analyses in the field of transcatheter and surgical aortic valve replacement with no direct personal compensation. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.