975-77 Gender Associated Differences in Asymptomatic Aortic Stenosis: Exercise Capacity, Functional Status, and Diastolic Left Ventricular Filling

In order to examine gender related differences in left ventricular geometry, diastolic filling. exercise capacity and functional status, 45 male and 24 female subjects with asymptomatic aortic stenosis (AS) were evaluated with 20 and Doppler echocardiography before and immediately after Bruce protocol treadmill exercise tests. Functional status was assessed by a standardized questionnaire using a 0–100% scale. There was no difference in AS severity between men and women (maximal AS jet velocity 3.5±0.6 vs 3.6±0.6 m/s. p=NS; aortic valve area index 0.7±0.2 vs 0.6±0.2 cm2/m2. p=NS). A comparison of men and women is shown (mean values±1 SD):MaleFemalepvalueAge Iyears)60±1565±19NSFunctional status score (%)95±788±140005End-diastolic volume index (ml/m2)48±1442±150.09End-systolic volume index (ml/m2)16±714±6NSEjection fraction (%)67±667±10NSEvelocity time integral (cm)92±7416.2±7.60001Avelocity time integral (cm)6.2±5.110.0±5.10005Exercise treadmill duration (mins)80±3.94.5±4.10.001Functional aerobic impairment (%)2±3325±480.02Resting heart rate (bpm)70±1575±15NSPeak heart rate (bpm)148±29141±26NSPeak stroke volume index (ml/m2)51±1547±16NSPeak cardiac output (1/min)15.5±5911.4±4.00004Peak cardiac index (I/min/m2)7.7±2.86.7±2.7NSChange in cardiac index (1/min/m2)4.0±2.13.2±2.3017ConclusionsIn AS patients without clinical symptoms. women have lower exercise capacity and functional status than men even though measures of LV function and AS severity are similar. Decreased augmentation of cardiac output with exercise and altered diastolic filling patterns may explain these findings