ArticlePloS one2017
Sex-dependent aortic valve pathology in patients with rheumatic heart disease.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 15 citations in OpenAlex.
- Valve biology and rheumatic heart disease pathogenesis.Nature cardiovascular research · 2026Review
- Contraceptive Utilization and Lived Experiences of Women with Rheumatic Heart Disease Attending Uganda Heart Institute and Mbarara Regional Referral Hospital.International journal of women's health · 2025Article
- A Rare Case of Congestive Heart Failure due to Isolated Aortic Valve Disease in a Middle-Aged Man Secondary to Rheumatic Fever.Journal of medical cases · 2023Article
- The role of monocytes in thrombotic diseases: a review.Frontiers in cardiovascular medicine · 2023Review
- Atypical Expression of Smooth Muscle Markers and Co-activators and Their Regulation in Rheumatic Aortic and Calcified Bicuspid Valves.Frontiers in cardiovascular medicine · 2022Article
- Sex-Differences in Aortic Stenosis: Mechanistic Insights and Clinical Implications.Frontiers in cardiovascular medicine · 2022Article
- Matters of the heart: Cellular sex differences.Journal of molecular and cellular cardiology · 2021Review
- Age, Sex, and Valve Phenotype Differences in Fibro-Calcific Remodeling of Calcified Aortic Valve.Journal of the American Heart Association · 2020Article
- Comparative Clinical Characteristics of Rheumatic Heart Disease Patients Undergoing Surgical Valve Replacement.Cureus · 2019Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundRheumatic heart disease is an autoimmune disease caused by group A streptococci infection and frequently affects the aortic valve. Sex differences are common in the disease progression, treatment, and outcome. However, little is known about the sex differences in the pathology of aortic valves in rheumatic heart disease.
designWe studied the end-stage calcific aortic valves from male versus female patients to reveal the sex-dependent pathology differences and molecular changes associated with requiring valve replacement.
methodsAortic valves from 39 patients with rheumatic heart disease (19 males and 20 females) were collected at the time of aortic valve replacement for comparative pathology, immunohistochemistry, and gene expression analyses. Clinical characteristics were also analyzed and compared between the two groups.
resultsAortic valves from female patients exhibited increased expression of collagens, infiltration of monocytes/macrophages and neovascularization. Aortic valves from female patients also had increased expression of inflammatory genes involved in the NFKB pathway (phosphorylated NFKB p65 subunit, IL8, and NOS3) and Th1 cytokine genes (IFNA and IL12B). The severe valve pathology in female patients was correlated with a higher serum level of anti-streptolysin O antibodies.
conclusionInflammation is more prominent in aortic valves of female patients with rheumatic heart disease. This sex difference may contribute to the severe valve pathology and worse outcome of female patients.
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