• William K F Kong, Madelien V Regeer, Arnold C T Ng, Louise McCormack, Kian Keong Poh, Tiong Cheng Yeo, Miriam Shanks, Sarah Parent, Roxana Enache, Bogdan A Popescu, James W Yip, Lawrence Ma, Vasileios Kamperidis, Enno T van der Velde, Bart Mertens, Nina Ajmone Marsan, Victoria Delgado, and Jeroen J Bax.
• From the Department of Cardiology (W.K.F.K., M.V.R., V.K., E.T.v.d.V., N.A.M., V.D., J.J.B.) and Medical Statistics Department (B.M.), Leiden University Medical Center, The Netherlands; Department of Cardiology, National University Heart Centre, National University Health System, Singapore (W.K.F.K., K.K.P., T.C.Y., J.W.Y.); Department of Cardiology, Princess Alexandra Hospital, The University of Queensland, St Lucia, Australia (A.C.T.N., L.M.C., L.M.); Division of Cardiology, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (M.S., S.P.); University of Medicine and Pharmacy "Carol Davila", Department of Cardiology-Euroecolab, Institute of Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Bucharest, Romania (R.E., B.A.P.); and Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece (V.K.).
• Circ Cardiovasc Imaging. 2017 Mar 1; 10 (3).

BackgroundThis large multicenter, international bicuspid aortic valve (BAV) registry aimed to define the sex differences in prevalence, valve morphology, dysfunction (aortic stenosis/regurgitation), aortopathy, and complications (endocarditis and aortic dissection).Methods And ResultsDemographic, clinical, and echocardiographic data at first presentation of 1992 patients with BAV (71.5% men) were retrospectively analyzed. BAV morphology and valve function were assessed; aortopathy configuration was defined as isolated dilatation of the sinus of Valsalva or sinotubular junction, isolated dilatation of the ascending aorta distal to the sinotubular junction, or diffuse dilatation of the aortic root and ascending aorta. New cases of endocarditis and aortic dissection were recorded. There were no significant sex differences regarding BAV morphology and frequency of normal valve function. When presenting with moderate/severe aortic valve dysfunction, men had more frequent aortic regurgitation than women (33.8% versus 22.2%, P<0.001), whereas women were more likely to have aortic stenosis (34.5% versus 44.1%, P<0.001). Men had more frequently isolated dilatation of the sinus of Valsalva or sinotubular junction (14.2% versus 6.7%, P<0.001) and diffuse dilatation of the aortic root and ascending aorta (16.2% versus 7.3%, P<0.001) than women. Endocarditis (4.5% versus 2.5%, P=0.037) and aortic dissections (0.5% versus 0%, P<0.001) occurred more frequently in men.ConclusionsAlthough there is a male predominance among patients with BAV, men with BAV had more frequently moderate/severe aortic regurgitation at first presentation compared with women, whereas women presented more often with moderate/severe aortic stenosis compared with men. Furthermore, men had more frequent aortopathy than women.© 2017 American Heart Association, Inc.

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