ArticleEuropean heart journal2025
Sex-related differences in the clinical course of aortic root and ascending aortic aneurysms: the DisSEXion Study.
Article in European heart journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Sex-related differences in histopathology and hormonal associations in ascending aortic aneurysms.European heart journal open · 2026Article
- Sex differences in outcomes of a two-stage approach to aortic arch surgery: 8-year experience of a national aortovascular centre.Journal of cardiothoracic surgery · 2026Article
- Sex-Specific Growth Rates of Ascending Thoracic Aortic Aneurysms in Non-Syndromic Patients: A Systematic Review.Diagnostics (Basel, Switzerland) · 2026Review
- 2025 report on advances in thoracic aortic disease research.Journal of thoracic disease · 2026Review
- Article
- Sex-Specific Characteristics of Perivascular Fat in Aortic Aneurysms.Journal of clinical medicine · 2025Review
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12 authors.
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Abstract
BACKGROUND AND
aimsTo explore male-female differences in aneurysm growth and clinical outcomes in a two-centre retrospective Dutch cohort study of adult patients with ascending aortic aneurysm (AscAA).
methodsAdult patients in whom imaging of an AscAA (root and/or ascending: ≥40 mm) was performed between 2007 and 2022 were included. Aneurysm growth was analysed using repeated measurements at the sinuses of Valsalva (SoV) and tubular ascending aorta. Male-female differences were explored in presentation, aneurysm characteristics, treatment strategy, survival, and clinical outcomes.
resultsOne thousand eight hundred and fifty-eight patients were included (31.6% female). Median age at diagnosis was 65.4 years (interquartile range: 53.4-71.7) for females and 59.0 years (interquartile range: 49.3-68.0) for males (P < .001). At diagnosis, females more often had tubular ascending aortic involvement (75.5% vs. 70.2%; P = .030) while males more often had SoV involvement (42.8% vs. 21.6%; P < .001). Maximum absolute aortic diameter, at any location, at diagnosis did not differ between females (45.0 mm) and males (46.5 mm; P = .388). In females, tubular ascending growth was faster (P < .001), whereas in males, SoV growth was faster (P = .005), corrected for covariates. Unadjusted 10-year survival was 72.5% [95% confidence interval (CI) 67.8%-77.6%] for females and 78.3% (95% CI 75.3%-81.3%) for males (P = .010). Twenty-three type A dissections occurred, with an incidence rate of 8.2/1000 patient-years (95% CI 4.4-14.1) in females and 2.4/1000 patient-years (95% CI 1.2-4.5) in males [incidence rate ratio females/males: 3.4 (95% CI 1.5-8.0; P = .004)].
conclusionsIn patients having entered a diagnostic programme, involvement of aortic segments and age- and segment-related growth patterns differ between women and men with AscAA, particularly at an older age. Unravelling of these intertwined observations will provide a deeper understanding of AscAA progression and outcome in women and men and can be used as an evidence base for patient-tailored clinical guideline development.
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