Impact of Myocardial Fibrosis in Patients With Symptomatic Severe Aortic Stenosis
Frank Weidemann,Sebastian Herrmann,Stefan Störk,Markus Niemann,Stefan Frantz,Volkmar Lange,Meinrad Beer,Stefan Gattenlöhner,Wolfram Voelker,Georg Ertl,Jörg Strotmann +10 more
Reads0
Chats0
TLDR
Myocardial fibrosis is an important morphological substrate of postoperative clinical outcome in patients with severe aortic stenosis and was not reversible after AVR over the 9 months of follow-up examined in this study.Abstract:
Background In this prospective follow-up study, the effect of myocardial fibrosis on myocardial performance in symptomatic severe aortic stenosis was investigated, and the impact of fibrosis on clinical outcome after aortic valve replacement (AVR) was estimated. Methods and results Fifty-eight consecutive patients with isolated symptomatic severe aortic stenosis underwent extensive baseline characterization before AVR. Standard and tissue Doppler echocardiography and cardiac magnetic resonance imaging (late-enhancement imaging for replacement fibrosis) were performed at baseline and 9 months after AVR. Endomyocardial biopsies were obtained intraoperatively to determine the degree of myocardial fibrosis. Patients were analyzed according to the severity of interstitial fibrosis in cardiac biopsies (severe, n=21; mild, n=15; none, n=22). The extent of histologically determined cardiac fibrosis at baseline correlated closely with New York Heart Association functional class and markers of longitudinal systolic function (all P Conclusions Myocardial fibrosis is an important morphological substrate of postoperative clinical outcome in patients with severe aortic stenosis and was not reversible after AVR over the 9 months of follow-up examined in this study. Because markers of longitudinal systolic function appear to indicate sensitively both the severity of myocardial fibrosis and the clinical outcome, they may prove valuable for preoperative risk assessment in patients with aortic stenosis.read more
Citations
More filters
Journal ArticleDOI
Current and evolving echocardiographic techniques for the quantitative evaluation of cardiac mechanics: ASE/EAE consensus statement on methodology and indications: Endorsed by the Japanese Society of Echocardiography
Victor Mor-Avi,Roberto M. Lang,Luigi P. Badano,Marek Belohlavek,Nuno Cardim,Geneviève Derumeaux,Maurizio Galderisi,Thomas H. Marwick,Sherif F. Nagueh,Partho P. Sengupta,Rosa Sicari,Otto A. Smiseth,Beverly Smulevitz,Masaaki Takeuchi,James D. Thomas,Mani A. Vannan,Jens-Uwe Voigt,José Luis Zamorano +17 more
TL;DR: Currently available techniques that allow quantitative assessment of myocardial function via image-based analysis of local myocardials dynamics, including Doppler tissue imaging and speckle-tracking echocardiography, as well as integrated backscatter analysis are described.
Journal ArticleDOI
The pathogenesis of cardiac fibrosis
TL;DR: Both experimental and clinical evidence suggests that cardiac fibrotic alterations may be reversible, and understanding the mechanisms responsible for initiation, progression, and resolution of cardiac fibrosis is crucial to design anti-fibrotic treatment strategies for patients with heart disease.
Journal ArticleDOI
Recommendations on the Echocardiographic Assessment of Aortic Valve Stenosis: A Focused Update from the European Association of Cardiovascular Imaging and the American Society of Echocardiography
Helmut Baumgartner,Judy Hung,Javier Bermejo,John B. Chambers,Thor Edvardsen,Steven A. Goldstein,Patrizio Lancellotti,Melissa LeFevre,Fletcher A. Miller,Catherine M Otto +9 more
TL;DR: This document focuses in particular on the optimization of left ventricular outflow tract assessment, low flow, low gradient aortic stenosis with preserved ejection fraction, and a grading algorithm for an integrated and stepwise approach of aorti stenosis assessment in clinical practice.
Journal ArticleDOI
Equilibrium Contrast Cardiovascular Magnetic Resonance for the Measurement of Diffuse Myocardial Fibrosis Preliminary Validation in Humans
Andrew S. Flett,Martin Hayward,Michael Ashworth,Michael S. Hansen,Andrew M. Taylor,Perry M. Elliott,Christopher G.A. McGregor,James C. Moon +7 more
TL;DR: A robust and noninvasive technique, equilibrium contrast CMR (EQ–CMR), is developed and validated to measure diffuse myocardial fibrosis as an add-on to a standard CMR scan, which allows for the nonin invasive quantification of the diffuse fibrosis burden in myocardIAL diseases.
Journal ArticleDOI
Assessment of Myocardial Fibrosis With Cardiovascular Magnetic Resonance
Nathan Mewton,Chia Ying Liu,Pierre Croisille,David A. Bluemke,David A. Bluemke,Joao A.C. Lima +5 more
TL;DR: Cardiovascular magnetic resonance (CMR) may uniquely characterize the extent of replacement fibrosis and may have prognostic value in various cardiomyopathies.
References
More filters
Journal ArticleDOI
ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease
Robert O. Bonow,Blase A. Carabello,Kanu Chatterjee,Antonio C. de Leon,David P. Faxon,Michael D. Freed,William H. Gaasch,Bruce W. Lytle,Rick A. Nishimura,Patrick T. O'Gara,Robert A. O'Rourke,Catherine M Otto,Pravin M. Shah,Jack S. Shanewise +13 more
TL;DR: It is important that the medical profession play a significant role in critically evaluating the use of diagnostic procedures and therapies as they are introduced in the detection, management, and management of diseases.
Journal ArticleDOI
Standardized Myocardial Segmentation and Nomenclature for Tomographic Imaging of the Heart A Statement for Healthcare Professionals From the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association
Manuel D. Cerqueira,Neil J. Weissman,Vasken Dilsizian,Alice K. Jacobs,Sanjiv Kaul,Warren K. Laskey,Dudley J. Pennell,John A. Rumberger,Thomas J. Ryan,Mario S. Verani +9 more
TL;DR: Attempts to standardize options for all cardiac imaging modalities should be based on the sound principles that have evolved from cardiac anatomy and clinical needs, and selection of standardized methods must bebased on the following criteria.
Journal ArticleDOI
Guidelines on the management of valvular heart disease The Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology
Alec Vahanian,Helmut Baumgartner,Jeroen J. Bax,Butchart Eg,Robert Dion,Gerasimos Filippatos,Frank A. Flachskampf,Roger Hall,Bernard Iung,Jarosław D. Kasprzak,Patrick Nataf,Pilar Tornos,Lucia Torracca,Arnold Wenink,Silvia G. Priori,Jean-Jacques Blanc,Andrzej Budaj,John Camm,Veronica Dean,Jaap W. Deckers,Kenneth Dickstein,John Lekakis,Keith McGregor,Marco Metra,João Morais,Ady Osterspey,Juan Tamargo,José Luis Zamorano,Annalisa Angelini,Manuel J. Antunes,Miguel Ángel García Fernández,Christa Gohlke-Baerwolf,Gilbert Habib,John J.V. McMurray,Catherine M Otto,Luc Pierard,José L. Pomar,Bernard Prendergast,Raphael Rosenhek,Miguel Sousa Uva +39 more
TL;DR: Guidelines and Expert Consensus Documents aim to present management recommendations based on all of the relevant evidence on a particular subject in order to help physicians select the best possible management strategies for the individual patient suffering from a specific condition, taking into account the impact on outcome and also the risk–benefit ratio of a particular diagnostic or therapeutic procedure.
Journal ArticleDOI
Progression From Compensated Hypertrophy to Failure in the Pressure-Overloaded Human Heart Structural Deterioration and Compensatory Mechanisms
Stefan Hein,Eyal Arnon,Sawa Kostin,Markus Schönburg,Albrecht Elsässer,V. Polyakova,Erwin P. Bauer,Wolf-Peter Klövekorn,Jutta Schaper +8 more
TL;DR: These structure-function correlations confirm the hypothesis that transition to HF occurs by fibrosis and myocyte degeneration partially compensated by hypertrophy involving DNA synthesis and transcription.
Journal ArticleDOI
Paradoxical Low-Flow, Low-Gradient Severe Aortic Stenosis Despite Preserved Ejection Fraction Is Associated With Higher Afterload and Reduced Survival
TL;DR: A comprehensive evaluation of the clinical and Doppler echocardiographic data of 512 consecutive patients with severe aortic stenosis shows that this pattern is in fact consistent with a more advanced stage of the disease and has a poorer prognosis.
Related Papers (5)
Guidelines on the management of valvular heart disease The Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology
Alec Vahanian,Helmut Baumgartner,Jeroen J. Bax,Butchart Eg,Robert Dion,Gerasimos Filippatos,Frank A. Flachskampf,Roger Hall,Bernard Iung,Jarosław D. Kasprzak,Patrick Nataf,Pilar Tornos,Lucia Torracca,Arnold Wenink,Silvia G. Priori,Jean-Jacques Blanc,Andrzej Budaj,John Camm,Veronica Dean,Jaap W. Deckers,Kenneth Dickstein,John Lekakis,Keith McGregor,Marco Metra,João Morais,Ady Osterspey,Juan Tamargo,José Luis Zamorano,Annalisa Angelini,Manuel J. Antunes,Miguel Ángel García Fernández,Christa Gohlke-Baerwolf,Gilbert Habib,John J.V. McMurray,Catherine M Otto,Luc Pierard,José L. Pomar,Bernard Prendergast,Raphael Rosenhek,Miguel Sousa Uva +39 more
Guidelines on the management of valvular heart disease (version 2012)
Alec Vahanian,Ottavio Alfieri,Felicita Andreotti,Manuel J. Antunes,Gonzalo Barón-Esquivias,Helmut Baumgartner,Michael A. Borger,Thierry Carrel,Michele De Bonis,Arturo Evangelista,Volkmar Falk,Bernard Iung,Patrizio Lancellotti,Luc Pierard,Susanna Price,Hans-Joachim Schäfers,Gerhard Schuler,Janina Stępińska,Karl Swedberg,Johanna J.M. Takkenberg,Ulrich O. von Oppell,Stephan Windecker,José Luis Zamorano,Marian Zembala +23 more
2017 ESC/EACTS Guidelines for the management of valvular heart disease
Helmut Baumgartner,Volkmar Falk,Jeroen J. Bax,Michele De Bonis,Christian W. Hamm,Per Johan Holm,Bernard Iung,Patrizio Lancellotti,Emmanuel Lansac,Daniel Rodriguez Muñoz,Raphael Rosenhek,Johan Sjögren,Pilar Tornos Mas,Alec Vahanian,Thomas Walther,Olaf Wendler,Stephan Windecker,José Luis Zamorano +17 more