{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T19:34:33Z","timestamp":1787081673242,"version":"build-2736575974"},"reference-count":63,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T00:00:00Z","timestamp":1744675200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Aortic stenosis (AS) is a progressive form of valvular heart disease most commonly associated with aging, with an exponential increase in prevalence after age 50. While men have historically been considered at higher risk, recent studies highlight a similar prevalence between men and women, with a higher prevalence in elderly women driven by longer life expectancy. Sex-related differences in clinical presentation, anatomy, and pathophysiology influence disease progression, severity assessment, and management. Women are often diagnosed at more advanced stages, exhibiting more pronounced symptoms, typically dyspnea and functional impairment, whereas men more often report chest pain. Women have a smaller body surface area, leading to smaller aortic annuli, left ventricular outflow tracts, aortic roots impacting flow dynamic, and severity grading. Diagnostic challenge contributes to the undertreatment of women. Despite experiencing severe AS, women receive fewer interventions and face delays in treatment. The advent of transcatheter aortic valve implantation (TAVI) improved outcomes, with studies suggesting a potential advantage in women compared to men. However, the anatomical differences, such as smaller annuli and more tortuous vascular access, necessitate tailored procedural approaches. Recognizing these sex-specific differences is essential to optimizing AS management, ensuring timely interventions, and improving patient outcomes. Future strategies should incorporate sex-specific thresholds for diagnosis and treatment while leveraging technological advancements, such as artificial intelligence, for personalized therapeutic decisions.<\/jats:p>","DOI":"10.3390\/jcm14082691","type":"journal-article","created":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T03:59:06Z","timestamp":1744689546000},"page":"2691","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Aortic Stenosis: Time for a Sex-Based Approach?"],"prefix":"10.3390","volume":"14","author":[{"given":"Aurelia","family":"Zimmerli","sequence":"first","affiliation":[{"name":"Service of Cardiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6529-1181","authenticated-orcid":false,"given":"Quentin","family":"Liabot","sequence":"additional","affiliation":[{"name":"Service of Cardiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2810-8887","authenticated-orcid":false,"given":"Georgios","family":"Tzimas","sequence":"additional","affiliation":[{"name":"Service of Cardiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariama","family":"Akodad","sequence":"additional","affiliation":[{"name":"Institut Cardiovasculaire Paris-Sud (ICPS), H\u00f4pital Jacques Cartier, Ramsay-Sant\u00e9, 91300 Massy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adil","family":"Salihu","sequence":"additional","affiliation":[{"name":"Service of Cardiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8522-284X","authenticated-orcid":false,"given":"Victor","family":"Weerts","sequence":"additional","affiliation":[{"name":"Service of Cardiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8466-7360","authenticated-orcid":false,"given":"Panagiotis","family":"Antiochos","sequence":"additional","affiliation":[{"name":"Service of Cardiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie L.","family":"Sellers","sequence":"additional","affiliation":[{"name":"Dilawri Cardiovascular Institute, Vancouver General Hospital, Vancouver, BC V5Z 1M9, Canada"},{"name":"Cardiovascular Translational Laboratory, Providence Research and Centre for Heart Lung Innovation, St Paul\u2019s Hospital and University of British Columbia, Vancouver, BC V6Z 1Y6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3083-7333","authenticated-orcid":false,"given":"Pierre","family":"Monney","sequence":"additional","affiliation":[{"name":"Service of Cardiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Muller","sequence":"additional","affiliation":[{"name":"Service of Cardiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephane","family":"Fournier","sequence":"additional","affiliation":[{"name":"Service of Cardiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5524-5844","authenticated-orcid":false,"given":"David","family":"Meier","sequence":"additional","affiliation":[{"name":"Service of Cardiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1161\/CIRCRESAHA.121.319914","article-title":"Sex differences and similarities in valvular heat disease","volume":"130","author":"DesJardin","year":"2022","journal-title":"Circ. 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