<div class="OutlineElement Ltr SCXW232889769 BCX0"> <p class="Paragraph SCXW232889769 BCX0" lang="EN-US" paraid="1635440304" paraeid="{7de8e708-25f4-4dd4-ba9c-71ecdf658114}{249}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW232889769 BCX0"><span class="NormalTextRun SCXW232889769 BCX0">A meta-analysis shows w</span><span class="NormalTextRun SCXW232889769 BCX0">omen are typically older, have more symptoms and have worse long-term clinical outcomes compared with men when undergoing intervention for primary mitral regurgitation</span><span class="NormalTextRun SCXW232889769 BCX0"><span> </span>(PMR)</span><span class="NormalTextRun SCXW232889769 BCX0">.</span></span><span class="EOP Selected SCXW232889769 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW232889769 BCX0"> <p class="Paragraph SCXW232889769 BCX0" lang="EN-US" paraid="1957067348" paraeid="{eb5f4fcb-e8a7-4c7a-b2bc-9952cac1f47e}{4}"><span class="NormalTextRun SCXW232889769 BCX0">These data were reported in a manuscript published online Friday in<span> </span></span><em><span class="NormalTextRun SCXW232889769 BCX0">JACC: Cardiovascular Imaging</span></em><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW232889769 BCX0"><span class="NormalTextRun SCXW232889769 BCX0"><span> </span>by Edouard Long, MSc, of King’s College London,<span> </span></span><span class="NormalTextRun SCXW232889769 BCX0">U.K., and Guy’s and St. Thomas’ NHS Foundation Trust, London, and colleagues from the U.S., the U.K. and Canada.</span></span><span class="EOP Selected SCXW232889769 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW232889769 BCX0"> <p class="Paragraph SCXW232889769 BCX0" lang="EN-US" paraid="1701210589" paraeid="{b31cba11-365e-46dc-a786-1238d0a9176b}{83}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW232889769 BCX0"><span class="NormalTextRun SCXW232889769 BCX0">Clinical studies<span> </span></span><span class="NormalTextRun SCXW232889769 BCX0">reveal contracting evidence about sex differences in PMR management. Long et al. evaluated the current guidelines for PMR intervention and looked at<span> </span></span><span class="NormalTextRun SCXW232889769 BCX0">the potential differences in outcomes between men and women.</span></span><span class="EOP Selected SCXW232889769 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW232889769 BCX0"> <p class="Paragraph SCXW232889769 BCX0" lang="EN-US" paraid="1456606745" paraeid="{c0f3e0b0-b1e4-4904-b093-bd50c6cf8131}{146}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW232889769 BCX0"><span class="NormalTextRun SCXW232889769 BCX0">Various electronic databases were used for this analysis, including MEDLINE, Embase, Web of<span> </span></span><span class="NormalTextRun ContextualSpellingAndGrammarErrorV2Themed SCXW232889769 BCX0">Science</span><span class="NormalTextRun SCXW232889769 BCX0"><span> </span>and Scopus. Individual studies were included if they<span> </span></span><span class="NormalTextRun SCXW232889769 BCX0">reported long-term outcomes</span><span class="NormalTextRun SCXW232889769 BCX0"><span> </span>— with sex outcomes examined —</span><span class="NormalTextRun SCXW232889769 BCX0"> in patients undergoing surgical or transcatheter PMR interventions</span><span class="NormalTextRun SCXW232889769 BCX0">.</span></span><span class="EOP Selected SCXW232889769 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW232889769 BCX0"> <p class="Paragraph SCXW232889769 BCX0" lang="EN-US" paraid="1940206459" paraeid="{4b19162b-b743-44d9-a92d-d4cf24faa7e5}{208}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW232889769 BCX0"><span class="NormalTextRun SCXW232889769 BCX0">All-cause death was the primary endpoint for the meta-analysis. Major adverse cardiovascular events (MACE)<span> </span></span><span class="NormalTextRun SCXW232889769 BCX0">made up</span><span class="NormalTextRun SCXW232889769 BCX0"><span> </span>the secondary endpoint.</span><span> </span></span><span class="EOP Selected SCXW232889769 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW232889769 BCX0"> <p class="Paragraph SCXW232889769 BCX0" lang="EN-US" paraid="1405767323" paraeid="{687c64bc-65fb-435f-b62d-3bd986a01024}{191}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW232889769 BCX0"><span class="NormalTextRun SCXW232889769 BCX0">A meta-regression was used on patient-level data-derived hazard ratios (HRs) with a linear mixed-effects model to<span> </span></span><span class="NormalTextRun SCXW232889769 BCX0">determine</span><span class="NormalTextRun SCXW232889769 BCX0"><span> </span>the sex differences</span><span class="NormalTextRun SCXW232889769 BCX0"><span> </span>in baseline characteristics.</span></span><span class="EOP Selected SCXW232889769 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW232889769 BCX0"> <p class="Paragraph SCXW232889769 BCX0" lang="EN-US" paraid="460711899" paraeid="{4a095ae5-0402-4acb-bc7f-92d7e23c4808}{49}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW232889769 BCX0"><span class="NormalTextRun SCXW232889769 BCX0">Investigators found 17 studies to include in this meta-analysis (37.5% women). Women were significantly older than men (mean difference=3.2 years; 95% confidence interval [CI]=2.2-4.3).<span> </span></span><span class="NormalTextRun SCXW232889769 BCX0">Women also had more heart failure symptoms than men at baseline (odds ratio [OR]=1.8; 95% CI=1.6-2.1).<span> </span></span></span><span class="EOP Selected SCXW232889769 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW232889769 BCX0"> <p class="Paragraph SCXW232889769 BCX0" lang="EN-US" paraid="2107069076" paraeid="{187f9699-ae2d-47d1-8f8a-2f407e48734c}{237}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW232889769 BCX0"><span class="NormalTextRun SCXW232889769 BCX0">At 15.7-year follow-up, women were more likely to die<span> </span></span><span class="NormalTextRun SCXW232889769 BCX0">compared with</span><span class="NormalTextRun SCXW232889769 BCX0"> men (HR=1.15; 95% CI=1.07).</span><span class="NormalTextRun SCXW232889769 BCX0"><span> </span>Overall, women were more likely to have MACE (n=2,775; HR=1.37; 95% CI=1.11-1.70).</span></span><span class="EOP Selected SCXW232889769 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW232889769 BCX0"> <p class="Paragraph SCXW232889769 BCX0" lang="EN-US" paraid="50079030" paraeid="{2d2397f1-b13d-4af2-bac6-5a5c4cf55ade}{2}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW232889769 BCX0"><span class="NormalTextRun SCXW232889769 BCX0">Moderators of sex differences in mortality after undergoing intervention included age, moderate or greater tricuspid regurgitation (TR) and concomitant tricuspid valve repair (</span><span class="NormalTextRun SpellingErrorV2Themed SCXW232889769 BCX0">TVr</span><span class="NormalTextRun SCXW232889769 BCX0">).</span></span><span class="EOP Selected SCXW232889769 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW232889769 BCX0"> <p class="Paragraph SCXW232889769 BCX0" lang="EN-US" paraid="383261811" paraeid="{57d6bdfb-1f7b-4e40-a49b-54c20799923d}{111}"><span class="NormalTextRun SCXW232889769 BCX0">“</span><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW232889769 BCX0"><span class="NormalTextRun SCXW232889769 BCX0">A greater proportion of ≥ moderate TR and<span> </span></span><span class="NormalTextRun SpellingErrorV2Themed SCXW232889769 BCX0">TVr</span><span class="NormalTextRun SCXW232889769 BCX0"><span> </span>in women conferred increased mortality<span> </span></span><span class="NormalTextRun SCXW232889769 BCX0">relative</span><span class="NormalTextRun SCXW232889769 BCX0"><span> </span>to men. Neither left ventricular nor left atrial parameters significantly moderated sex differences in all-cause mortality (all p> 0.05),” the authors noted.</span></span><span class="EOP Selected SCXW232889769 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW232889769 BCX0"> <p class="Paragraph SCXW232889769 BCX0" lang="EN-US" paraid="844284417" paraeid="{187f9699-ae2d-47d1-8f8a-2f407e48734c}{226}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW232889769 BCX0"><span class="NormalTextRun SCXW232889769 BCX0">Several limitations exist in this review, including study selection criteria and selection bias, potential ecological bias and overfitting from the study-level meta-regression,<span> </span></span><span class="NormalTextRun SCXW232889769 BCX0">concomitant procedures between studies (such as ablation and coronary artery bypass grafting [CABG]), lack of data on procedural complications and lack of inclusion of PMR<span> </span></span><span class="NormalTextRun SCXW232889769 BCX0">pathophysiological entities outside the current international PMR guidelines.</span></span><span class="EOP Selected SCXW232889769 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW232889769 BCX0"> <p class="Paragraph SCXW232889769 BCX0" lang="EN-US" paraid="880672704" paraeid="{dd741d53-9f4c-4a8a-8ec0-a6dfa920057a}{149}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW232889769 BCX0"><span class="NormalTextRun SCXW232889769 BCX0">Sex differences were clearly<span> </span></span><span class="NormalTextRun SCXW232889769 BCX0">demonstrated</span><span class="NormalTextRun SCXW232889769 BCX0"><span> </span>in patients undergoing intervention for PMR. Women treated for PMR are more likely to die, have more symptoms and have more adverse cardiovascular events versus men.</span></span><span class="EOP Selected SCXW232889769 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW232889769 BCX0"> <p class="Paragraph SCXW232889769 BCX0" lang="EN-US" paraid="1661980553" paraeid="{31b18560-2098-49a6-bae9-9f421d5445b3}{113}"><strong><span class="NormalTextRun SCXW232889769 BCX0">This study was funded by the Clinical Research Training Fellowship, British Heart Foundation, London.</span><span class="EOP Selected SCXW232889769 BCX0" data-ccp-props="{}"> </span></strong></p> </div> <div class="OutlineElement Ltr SCXW232889769 BCX0"> <p class="Paragraph SCXW232889769 BCX0" lang="EN-US" paraid="1822334977" paraeid="{dd741d53-9f4c-4a8a-8ec0-a6dfa920057a}{107}"><strong><span class="NormalTextRun SCXW232889769 BCX0">Source:</span><span class="EOP Selected SCXW232889769 BCX0" data-ccp-props="{}"> </span></strong></p> </div> <div class="OutlineElement Ltr SCXW232889769 BCX0"> <p class="Paragraph SCXW232889769 BCX0" paraid="914721675" paraeid="{a20f0a43-6d51-4fde-a8bb-f19f684feb9c}{160}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW232889769 BCX0"><span class="NormalTextRun SCXW232889769 BCX0">Long E, Hahn RT, Gulati M, et al.<span> </span></span><span class="NormalTextRun SCXW232889769 BCX0">Sex-related differences in outcomes and thresholds for interventions in primary mitral regurgitation: A systematic review and meta-analysis.<span> </span></span></span><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW232889769 BCX0"><span class="NormalTextRun SCXW232889769 BCX0"><em>JACC:</em> <em>C</em></span><em><span class="NormalTextRun SCXW232889769 BCX0">ard</span><span class="NormalTextRun SCXW232889769 BCX0">i</span><span class="NormalTextRun SCXW232889769 BCX0">ova</span><span class="NormalTextRun SCXW232889769 BCX0">sc </span><span class="NormalTextRun SpellingErrorV2Themed SCXW232889769 BCX0">Imag</span></em><span class="NormalTextRun SCXW232889769 BCX0">.<span> </span></span></span><span class="NormalTextRun SCXW232889769 BCX0">2026 July 24 (Article in Press).</span><span class="EOP Selected SCXW232889769 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW232889769 BCX0"> <p class="Paragraph SCXW232889769 BCX0" lang="EN-US" paraid="520459320" paraeid="{3c4fdea3-716f-463d-9fd7-97f9c0e5043c}{10}"><strong><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun MacChromeBold SCXW232889769 BCX0"><span class="NormalTextRun SCXW232889769 BCX0">Image Credit: </span><span class="NormalTextRun SpellingErrorV2Themed SCXW232889769 BCX0">Kiattisak</span> <span class="NormalTextRun SCXW232889769 BCX0">– stock.adobe.com</span></span><span class="EOP Selected SCXW232889769 BCX0" data-ccp-props="{}"> </span></strong></p> </div>