Sex Differences in Reverse Remodeling After Transcatheter Aortic Valve Replacement in Low-Flow Aortic Stenosis

Objectives Sex-specific differences in left ventricular (LV) remodeling after transcatheter aortic valve replacement (TAVR) in low-flow aortic stenosis (LFAS) remain incompletely defined, and the influence of LFAS subtype on remodeling by sex is uncertain. The authors sought to characterize post-TAVR remodeling in LFAS by sex and subtype and identify predictors of remodeling.Methods This retrospective cohort study included 488 patients with LFAS (303 men, 185 women) who underwent TAVR. Smoothed conditional mean curves assessed longitudinal changes in LV mass index (LVMi), relative wall thickness (RWT), and LV ejection fraction (LVEF) through 18 months. Linear mixed models identified predictors of remodeling.Results Women more often had paradoxical low-flow low-gradient (pLFLG) AS (58.4% vs 43.6%, P = .001), whereas men more often had classical low-flow low-gradient AS (31.4% vs 13.5%, P Conclusions Reverse remodeling after TAVR occurred in both sexes, but trajectories and predictors were sex-specific.