TY - JOUR
T1 - Exploring myocardial fibrosis in severe aortic stenosis
T2 - echo, CMR and histology data from FIB-AS study
AU - Balčiūnaitė, Giedrė
AU - Besusparis, Justinas
AU - Palionis, Darius
AU - Žurauskas, Edvardas
AU - Skorniakov, Viktor
AU - Janušauskas, Vilius
AU - Zorinas, Aleksejus
AU - Zaremba, Tomas
AU - Valevičienė, Nomeda
AU - Šerpytis, Pranas
AU - Aidietis, Audrius
AU - Ručinskas, Kęstutis
AU - Sogaard, Peter
AU - Glaveckaitė, Sigita
N1 - © 2022. The Author(s), under exclusive licence to Springer Nature B.V.
PY - 2022/7
Y1 - 2022/7
N2 - Myocardial fibrosis in aortic stenosis is associated with worse survival following aortic valve replacement. We assessed myocardial fibrosis in severe AS patients, integrating echocardiographic, cardiovascular magnetic resonance (CMR) and histological data. A total of 83 severe AS patients (age 66.4 ± 8.3, 42% male) who were scheduled for surgical AVR underwent CMR with late gadolinium enhancement and T1 mapping and global longitudinal strain analysis. Collagen volume fraction was measured in myocardial biopsies (71) that were sampled at the time of AVR. Results. CVF correlated with imaging and serum biomarkers of LV systolic dysfunction and left side chamber enlargement and was higher in the sub-endocardium compared with midmyocardium (p<0.001). CVF median values were higher in LGE-positive versus LGE-negative patients [28.7% (19-33) vs 20.7% (15-30), respectively, p=0.040]. GLS was associated with invasively (CVF; r=-0.303, p=0.013) and non-invasively (native T1; r=-0.321, p<0.05) measured myocardial fibrosis. GLS and native T1 correlated with parameters of adverse LV remodelling, systolic and diastolic dysfunction and serum biomarkers of heart failure and myocardial injury. Conclusion. Our data highlight the role of myocardial fibrosis in adverse cardiac remodelling in AS. GLS has potential as a surrogate marker of myocardial fibrosis, and high native T1 and low GLS values differentiated patients with more advanced cardiac remodelling.
AB - Myocardial fibrosis in aortic stenosis is associated with worse survival following aortic valve replacement. We assessed myocardial fibrosis in severe AS patients, integrating echocardiographic, cardiovascular magnetic resonance (CMR) and histological data. A total of 83 severe AS patients (age 66.4 ± 8.3, 42% male) who were scheduled for surgical AVR underwent CMR with late gadolinium enhancement and T1 mapping and global longitudinal strain analysis. Collagen volume fraction was measured in myocardial biopsies (71) that were sampled at the time of AVR. Results. CVF correlated with imaging and serum biomarkers of LV systolic dysfunction and left side chamber enlargement and was higher in the sub-endocardium compared with midmyocardium (p<0.001). CVF median values were higher in LGE-positive versus LGE-negative patients [28.7% (19-33) vs 20.7% (15-30), respectively, p=0.040]. GLS was associated with invasively (CVF; r=-0.303, p=0.013) and non-invasively (native T1; r=-0.321, p<0.05) measured myocardial fibrosis. GLS and native T1 correlated with parameters of adverse LV remodelling, systolic and diastolic dysfunction and serum biomarkers of heart failure and myocardial injury. Conclusion. Our data highlight the role of myocardial fibrosis in adverse cardiac remodelling in AS. GLS has potential as a surrogate marker of myocardial fibrosis, and high native T1 and low GLS values differentiated patients with more advanced cardiac remodelling.
KW - Aortic stenosis
KW - Cardiovascular magnetic resonance
KW - Global longitudinal strain
KW - Myocardial fibrosis
KW - T1 mapping
UR - http://www.scopus.com/inward/record.url?scp=85125535245&partnerID=8YFLogxK
U2 - 10.1007/s10554-022-02543-w
DO - 10.1007/s10554-022-02543-w
M3 - Journal article
C2 - 35239067
SN - 1569-5794
VL - 38
SP - 1555
EP - 1568
JO - International Journal of Cardiovascular Imaging
JF - International Journal of Cardiovascular Imaging
IS - 7
ER -