Objectives: To evaluate gender-specific differences in computed tomography (CT) measurements of patients with severe aortic stenosis (AS) referred for transcatheter aortic valve implantation (TAVI).
Background: Very little data exist on the impact of gender on CT measurements in patients referred for TAVI.
Methods: In our cohort of 442 patients (80 ± 8.5 years), there were 239 women and 203 men with severe AS who underwent 256-slice CT before TAVI. We assessed the impact of gender on aortic annulus cross-sectional area (CSA), perimeter (Perim), Sino-tubular junction (STJ), sinus of valsalva (SOV), ellipticity index (EI), and the distance of left and right coronary artery ostia from the aortic annulus plane. In a subgroup of 73 patients we evaluated the impact of gender on the aortic valve calcification (AVC), which was quantitatively evaluated by CT.
Results: Women had significantly smaller CSA (404 ± 73 vs. 506 ± 112 mm2), Perim (71.8 ± 7.6 vs. 80.1 ± 8.6 mm), STJ, (27.3 ± 29.4 mm), and SOV (32.5 ± 3.7 vs. 35.6 ± 4.6 mm) versus men; P < 0.001 for all, even after adjustment of the small body surface area in women. The EI was comparable between women and men (1.24 ± 0.12 vs. 1.25 ± 0.12, P = 0.7), and the mean left and right coronary artery ostia height were lower in women versus men (12.4 ± 2.7 vs. 13.9 ± 3 mm, P < 0.001; 14.8 ± 2.6 vs. 17 ± 3.2 mm, P < 0.001). AVC was borderline lower in women versus men (12 ± 6.7 cm3 vs. 14.3 ± 6.8 cm3, P = 0.1).
Conclusion: In this large severe AS population, women had smaller annulus, shallow SOV and STJ, and lower-lying coronary ostia, even after indexing for their smaller body size. The aortic annulus shape was similar in women and men and the valvular calcification in women had a trend towards lower value compared to men.
