Gender differences in primary mitral regurgitant volumes at specific regurgitant fractions as assessed by magnetic resonance imaging

Questions Regarding a Recent Study Comparing Mitral Regurgitant Volume Between Proximal Flow Convergence and Volumetric Methods: The Importance of Sex Differences

“…In addition, echocardiograms were obtained using platforms from different vendors, with potential intervendor discrepancies in the assessment of LV volumes by 3D TTE imaging. 4 Logically, 3D TTE and CMR volumetric methods display good agreement in studies involving the 3D TTE software from a single vendor. 2,3 This finding is not unexpected, as these two methods rely on the same pathophysiologic background.…”

“…3 Was there a specific reason why the authors chose to use biplane data in the current study and not continue with automated 3D echocardiography?We recently published on gender (sex) differences in mitral regurgitant volume at specific regurgitant fractions using MRI data. 4 In both sexes, regurgitant volume and regurgitant fraction are strongly correlated, but compared with men, women have a much lower regurgitant volume for any given regurgitant fraction. We found that a regurgitant fraction of 40% correlates with a regurgitant volume of approximately 60 mL in men and 40 mL in women.…”

Authors’ Reply

“…In a recent insightful study involving patients with primary MR with or without mitral valve prolapse, House et al 5 observed discrepancies between mitral RVol and RF according to sex, with notably lower mitral RVols in women compared with men (39.5 vs 59 mL) for a given mitral RF (40%). Indeed, in our study, the proportion of women was clearly higher in the group with CMR LV end-diastolic volume (LVEDV) # 172 mL compared with those with LVEDV > 172 mL (51% vs 13%; P < .001).…”