Ruggero De Paulis, Farhad Bakhtiary, Ali El-Sayed Ahmad, Martin Andreas, Rüdiger Autschbach, Peter Benedikt, Konrad Binder, Nikolaos Bonaros, Michael Borger, Thierry Bourguignon, Sergio Canovas, Enrico Coscioni, Francois Dagenais, Philippe Demers, Oliver Dewald, Nicolas Doll, Richard Feyrer, Hans-Joachim Geißler, Martin Grabenwöger, Jürg Grünenfelder, Sami Kueri, Ka Yan Lam, Thierry Langanay, Günther Laufer, Wouter Van Leeuwen, Seymur Karimli, Andreas Liebold, Giovanni Mariscalco, Parwis Massoudy, Arash Mehdiani, Renzo Pessotto, Francesco Pollari, Jochen Pöling, Gianluca Polvani, Alessandro Ricci, Jean-Christian Roussel, Saad Salamate, Matthias Siepe, Pierluigi Stefano, Justus Strauch, Alexis Theron, Andreas Vötsch, Alberto Weber, Olaf Wendler, Matthias Thielmann, Matthias Eden, Beate Botta, Peter Bramlage, Bart Meuris, Andreas Zierer
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引用次数: 0
Abstract
Objectives: This study investigated the Gender-based difference in 3-year clinical outcomes, left ventricular (LV) regression, and Quality-of-life (QoL) following surgical aortic valve replacement (SAVR) by propensity-score matching (PSM).
Methods: A prospective multicentre study on combined data from two prospective registries, INDURE and IMPACT, resulted in 993 patients (735 males and 258 females). PSM yielded 689 patients: 442 males and 247 females undergoing first-time SAVR using Edwards INSPIRIS RESILIA.
Results: In the PSM cohort, females had lower body mass index (median 27.9 vs 28.6 kg/m2; p = 0.004), higher EuroSCORE II (2.4 ± 3.0% vs 1.8 ± 1.9%; p < 0.001), STS score (1.8 ± 1.7% vs 1.3 ± 2.0%; p < 0.001) and were most often in NewYork Heart Association class III/IV (45.7% vs 37.6%; p < 0.021), angina CCS class III/IV (6.1% vs 2.9%; p < 0.001) than male. Post-SAVR clinical outcomes up to 3 years were similar between both genders. Significant differences existed for LV regression after surgery between genders at up to three years (p < 0.001) with better haemodynamic performance. Hypertension slowed the LV mass regression, mildly affecting LV restoration in females for up to 3 years. In both genders, NYHA status was restored within one year (p < 0.001) and maintained for up to 3 years (p < 0.001). At 3-years, QoL significantly improved.
Conclusions: Despite females presenting with a significantly higher surgical risk profile, 3-year outcomes following SAVR were comparable between genders with significant improvement in functional status. However, the degree of QoL improvement differed between genders.
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