Exploring myocardial fibrosis in severe aortic stenosis: echo, CMR and histology data from FIB-AS study

Giedrė Balčiūnaitė*, Justinas Besusparis, Darius Palionis, Edvardas Žurauskas, Viktor Skorniakov, Vilius Janušauskas, Aleksejus Zorinas, Tomas Zaremba, Nomeda Valevičienė, Pranas Šerpytis, Audrius Aidietis, Kęstutis Ručinskas, Peter Sogaard, Sigita Glaveckaitė

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

5 Citations (Scopus)


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.

Original languageEnglish
JournalInternational Journal of Cardiovascular Imaging
Issue number7
Pages (from-to)1555-1568
Number of pages14
Publication statusPublished - Jul 2022

Bibliographical note

© 2022. The Author(s), under exclusive licence to Springer Nature B.V.


  • Aortic stenosis
  • Cardiovascular magnetic resonance
  • Global longitudinal strain
  • Myocardial fibrosis
  • T1 mapping


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