Same Disease, Greater Risk
- SEOUL, South Korea (May 4, 2025) — Women with severe degenerative mitral valve regurgitation face a substantially higher risk of death in the early stages of the disease...
- The research, conducted by a team at Seoul Asan Hospital and Seoul National University Hospital, examined data from 1,686 patients who underwent surgery for the condition between 2006...
- Symptoms of mitral valve regurgitation can include shortness of breath, fatigue, edema, decreased appetite, and fainting.
Study: Women Face Higher Mortality Risk From Early-stage mitral Valve Regurgitation
Table of Contents
- Study: Women Face Higher Mortality Risk From Early-stage mitral Valve Regurgitation
- Study: Women Face Higher Mortality Risk from Early-Stage Mitral Valve regurgitation
- What is Mitral Valve Regurgitation?
- What are the Symptoms of Mitral Valve Regurgitation?
- Current Treatment for Mitral Valve Regurgitation
- How is Surgery for Mitral Valve Regurgitation Decided?
- Key Findings: Gender Disparities and Mortality
- Summary of Mortality Risks Based on Key Findings
- Expert Commentary: What Do the Experts Say?
- Where Was This Study Published?
SEOUL, South Korea (May 4, 2025) — Women with severe degenerative mitral valve regurgitation face a substantially higher risk of death in the early stages of the disease compared to men, according to a recent study.
Mitral Valve Regurgitation: A Gendered Viewpoint
The research, conducted by a team at Seoul Asan Hospital and Seoul National University Hospital, examined data from 1,686 patients who underwent surgery for the condition between 2006 and 2020. Mitral valve regurgitation occurs when the mitral valve, positioned between the heart’s left atrium and left ventricle, fails to close completely. This malfunction causes blood to flow backward into the left atrium during ventricular contraction.
Symptoms of mitral valve regurgitation can include shortness of breath, fatigue, edema, decreased appetite, and fainting. If left untreated, the condition can lead to increased strain on the left ventricle, reduced blood volume throughout the body, and ultimately, heart failure or death.
Current Treatment and the Left Ventricular Perspective
The standard treatment for severe degenerative mitral valve regurgitation involves open-chest surgery to repair or replace the existing valve with an artificial one.
Decisions regarding surgery are frequently enough based on the “left ventricular perspective,” which considers factors such as the ratio of blood ejected from the left ventricle (left ventricular ejection fraction) and the rate of left ventricular axial transformation. Surgery is typically recommended if the left ventricular ejection fraction falls below 60%, even in the absence of noticeable symptoms.
Key Findings: Gender Disparities in Mortality
The researchers’ analysis revealed a critical link between left ventricular function, gender, and mortality rates. While mortality rates increased significantly for all patients when the left ventricular ejection fraction dropped below 55%, a notable difference emerged between men and women.
Specifically, women with a left ventricular ejection fraction between 55% and 60% exhibited a similar mortality rate to those with a fraction below 55%. Further analysis indicated that women with a left ventricular ejection fraction below 55% faced a 3.48 times greater risk of death compared to those with a fraction of 60% or higher. This disparity was not observed in men.
Similar results were obtained when analyzing the rate of ventricular axis transformation. Regardless of symptom severity, women’s mortality rates increased as the left ventricular axis transformation rate decreased. In contrast, men only showed a significantly higher mortality rate in the group with the lowest transformation rate (less than 19.9%).
The findings suggest that women may experience more severe consequences from mitral valve regurgitation with less damage than men.
Expert Commentary and Future Directions
According to Professor Kim Dae-hee,a cardiology professor at Seoul Asan Hospital,the left ventricular axis transformation rate serves as a precise indicator for predicting the prognosis of severe mitral valve regurgitation,even in patients without symptoms or with a normal left ventricular ejection fraction.
Kim emphasized the need for customized surgical guidelines that account for gender differences in the treatment of severe mitral valve regurgitation.”We need to prepare customized surgery guidelines that reflect gender differences in the treatment of severe mitral reflux,” Kim said.
Study Details
The study, supported by the Ministry of Health and Welfare and the Korea Health Industry Promotion Agency, was published in JAMA Network Open, a journal of the American Medical Association.
Study: Women Face Higher Mortality Risk from Early-Stage Mitral Valve regurgitation
What is Mitral Valve Regurgitation?
Mitral valve regurgitation occurs when the mitral valve, situated between the heart’s left atrium and left ventricle, doesn’t close completely. This allows blood to flow backward into the left atrium during ventricular contraction. According to a study, women with this condition in its early stages face a higher risk of death compared to men.
What are the Symptoms of Mitral Valve Regurgitation?
Symptoms can include:
- Shortness of breath
- Fatigue
- Edema (swelling)
- Decreased appetite
- fainting
Current Treatment for Mitral Valve Regurgitation
The standard treatment for severe degenerative mitral valve regurgitation involves open-chest surgery. This surgery repairs or replaces the existing valve with an artificial one.
How is Surgery for Mitral Valve Regurgitation Decided?
Decisions about surgery often consider the ”left ventricular perspective.” This viewpoint examines factors like:
- The ratio of blood ejected from the left ventricle (left ventricular ejection fraction)
- The rate of left ventricular axial transformation
Surgery is usually recommended if the left ventricular ejection fraction falls below 60%, even without noticeable symptoms.
Key Findings: Gender Disparities and Mortality
The study highlighted a connection between left ventricular function, gender, and mortality rates. The results showed a clear difference in mortality risks between men and women.
How Dose Left Ventricular Ejection Fraction Impact Mortality?
While the mortality rate increased when the left ventricular ejection fraction dropped below 55% for all patients, women showed a substantially higher risk than men.
What is the Increased Mortality Risk for Women?
women with a left ventricular ejection fraction between 55% and 60% had a similar mortality rate to those with a fraction below 55%. Additionally, women with a left ventricular ejection fraction below 55% faced a 3.48 times greater risk of death compared to those with a fraction of 60% or higher. This disparity was not observed in men.
How Does Ventricular Axis Transformation Rate Affect mortality?
Women’s mortality rates increased as the rate of ventricular axis transformation decreased, regardless of the severity of symptoms.Men only showed a significantly higher mortality rate in the group with the lowest transformation rate (less than 19.9%).
Summary of Mortality Risks Based on Key Findings
The following table summarizes the key findings regarding mortality risks in men and women with mitral valve regurgitation:
| Factor | Women | Men |
|---|---|---|
| Left Ventricular Ejection Fraction (55-60%) | Similar mortality to those below 55% | No significant difference observed |
| Left Ventricular Ejection Fraction (Below 55%) | 3.48 times increased risk of death compared to those with a fraction of 60% or higher | No significant difference observed |
| Ventricular Axis Transformation Rate | Increased mortality as the rate decreased,regardless of symptom severity | Significantly higher mortality only in the group with the lowest transformation rate (less than 19.9%) |
Expert Commentary: What Do the Experts Say?
Professor Kim dae-hee, from Seoul Asan Hospital, stated that the left ventricular axis transformation rate is a precise indicator for predicting the prognosis of severe mitral valve regurgitation, even in patients without symptoms or with a normal left ventricular ejection fraction.
What Are the Implications of These Findings?
The findings stress the need for customized surgical guidelines that consider gender differences in treating severe mitral valve regurgitation.
Where Was This Study Published?
The study was published in JAMA Network Open, a journal of the American Medical Association.