Time to Integrate Sex in Management of Aortic Valve Stenosis.

www.ECRjournal.com An increasing body of evidence demonstrates how sex influences the development of degenerative aortic valve stenosis (AS) at the aortic root, the valvular and the left ventricular (LV) levels. While the sex-specific impact of ageing and comorbidities promote differences in remodelling of the aortic root and the LV in AS,1,2 sex differences in tissue biology have been demonstrated in the aortic valve.3 These documented sex differences impact diagnosis, grading, treatment choice and outcome in AS. Still, sex-related differences are not well incorporated into current guidelines for the management of AS.4,5 In this special focus of European Cardiology Review, current evidence for sex differences in AS diagnosis and management is reviewed (Figure 1).6–8