{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T22:33:49Z","timestamp":1768084429977,"version":"3.49.0"},"reference-count":28,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,5,24]],"date-time":"2021-05-24T00:00:00Z","timestamp":1621814400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To analyze how left ventricular (LV) remodeling and hypertrophy geometry evolve after surgical aortic valve replacement (SAVR) in octogenarian patients, and identify potential sex\u2010related differences and implications for long\u2010term outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In 170 patients with aortic stenosis ([AS], age 80\u00a0\u00b1\u00a04\u00a0years, 59% women), hypertrophy geometry and remodeling (LV index) were reanalyzed one year post\u2010SAVR. The six\u2010year outcomes were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Pre\u2010SAVR, 65% of the women and 38.6% of the men (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001) showed adaptive remodeling. Concentric hypertrophy was prevalent in adaptive remodeling, and mixed and dilated hypertrophy were more prevalent in maladaptive remodeling. At one year, the remodeling patterns and sex distribution were similar to those observed pre\u2010SAVR, but the LV index decreased in women and increased in men (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.0001). Women with adaptive remodeling had a higher incidence of persistent concentric hypertrophy with higher LV filling pressures. Long\u2010term survival was better in women and worse in men with adaptive remodeling (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.039). Men with adaptive remodeling and men with concentric hypertrophy had the highest risk of cardiac death. This risk was similar between sexes for patients with maladaptive remodeling and dilated hypertrophy. Women with LV ejection fraction &gt;55% had a lower risk of cardiac death than men.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The long\u2010term outcomes of SAVR differ between sexes in older patients with AS and adaptive LV remodeling. The LV index facilitates studying the pathways of adaptation to AS. The follow\u2010up shifts help explain the sex differences in long\u2010term outcomes post\u2010SAVR. Concentric hypertrophy is associated with the highest risk of cardiac death in men.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.15122","type":"journal-article","created":{"date-parts":[[2021,5,24]],"date-time":"2021-05-24T13:31:09Z","timestamp":1621863069000},"page":"1095-1103","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Surgical aortic valve replacement and left ventricular remodeling: Survival and sex\u2010related differences"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9655-4440","authenticated-orcid":false,"given":"Giuseppe","family":"Barletta","sequence":"first","affiliation":[{"name":"Diagnostic Cardiology Careggi University Hospital  Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Riccarda","family":"Del Bene","sequence":"additional","affiliation":[{"name":"Diagnostic Cardiology Careggi University Hospital  Florence 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