LGE prevalence and patterns in severe aortic stenosis : When "junctional" means the same
Copyright © 2023. Published by Elsevier B.V..
BACKGROUND: Left ventricular (LV) remodeling in severe aortic valve stenosis (AS) is a complex process that goes beyond hypertrophic response. Reparative/replacement fibrosis is considered irreversible and has recognized value in both risk stratification and prognosis. Currently, cardiac magnetic resonance (CMR) is the gold-standard imaging technique for fibrosis identification through late gadolinium enhancement (LGE) assessment. However, its prevalence and distribution are quite variable among series. Our goal was to assess LGE prevalence and patterns in severe AS.
METHODOLOGY: Single-center prospective cohort of 140 patients with severe symptomatic high-gradient AS (mean age 72 ± 8 years; mean valvular transaortic gradient 61 ± 18 mmHg; mean LV ejection fraction by echocardiogram 58 ± 9%) undergoing surgical aortic valve replacement. Those with previous myocardial infarction and/or non-ischemic cardiomyopathy were excluded. All patients performed 1.5 T LGE-CMR prior to surgery.
RESULTS: Overall, 103 patients (74%) had non-ischemic LGE (median LGE mass 2.8 g [IQR 0.0-7.8] g), many of them with combined mid-wall and junctional enhancement pattern (36%). LGE was most frequently observed in the mid-basal segments of the interventricular septum. Seventy-four patients (53%) had non-exclusively junctional LGE. Contrary to those with junctional enhancement, patients with non-exclusively junctional LGE had higher LV volumes/mass, worse LV ejection fraction and worse global longitudinal strain.
CONCLUSION: Among patients with severe, symptomatic, high-gradient AS, LGE is frequent, primarily affecting the mid-basal interventricular septum. Contrary to junctional LGE, the presence of non-junctional LGE seems to correlate with adverse markers of LV remodeling.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:378 |
|---|---|
| Enthalten in: |
International journal of cardiology - 378(2023) vom: 01. Mai, Seite 159-163 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Maltês, Sérgio [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
AU0V1LM3JT |
|---|
| Anmerkungen: |
Date Completed 21.03.2023 Date Revised 27.06.2023 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.ijcard.2023.02.034 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM353342262 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM353342262 | ||
| 003 | DE-627 | ||
| 005 | 20231226055755.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.ijcard.2023.02.034 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1177.xml |
| 035 | |a (DE-627)NLM353342262 | ||
| 035 | |a (NLM)36828032 | ||
| 035 | |a (PII)S0167-5273(23)00250-4 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Maltês, Sérgio |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a LGE prevalence and patterns in severe aortic stenosis |b When "junctional" means the same |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 21.03.2023 | ||
| 500 | |a Date Revised 27.06.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023. Published by Elsevier B.V. | ||
| 520 | |a BACKGROUND: Left ventricular (LV) remodeling in severe aortic valve stenosis (AS) is a complex process that goes beyond hypertrophic response. Reparative/replacement fibrosis is considered irreversible and has recognized value in both risk stratification and prognosis. Currently, cardiac magnetic resonance (CMR) is the gold-standard imaging technique for fibrosis identification through late gadolinium enhancement (LGE) assessment. However, its prevalence and distribution are quite variable among series. Our goal was to assess LGE prevalence and patterns in severe AS | ||
| 520 | |a METHODOLOGY: Single-center prospective cohort of 140 patients with severe symptomatic high-gradient AS (mean age 72 ± 8 years; mean valvular transaortic gradient 61 ± 18 mmHg; mean LV ejection fraction by echocardiogram 58 ± 9%) undergoing surgical aortic valve replacement. Those with previous myocardial infarction and/or non-ischemic cardiomyopathy were excluded. All patients performed 1.5 T LGE-CMR prior to surgery | ||
| 520 | |a RESULTS: Overall, 103 patients (74%) had non-ischemic LGE (median LGE mass 2.8 g [IQR 0.0-7.8] g), many of them with combined mid-wall and junctional enhancement pattern (36%). LGE was most frequently observed in the mid-basal segments of the interventricular septum. Seventy-four patients (53%) had non-exclusively junctional LGE. Contrary to those with junctional enhancement, patients with non-exclusively junctional LGE had higher LV volumes/mass, worse LV ejection fraction and worse global longitudinal strain | ||
| 520 | |a CONCLUSION: Among patients with severe, symptomatic, high-gradient AS, LGE is frequent, primarily affecting the mid-basal interventricular septum. Contrary to junctional LGE, the presence of non-junctional LGE seems to correlate with adverse markers of LV remodeling | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Aortic stenosis | |
| 650 | 4 | |a Cardiac magnetic resonance | |
| 650 | 4 | |a Late gadolinium enhancement | |
| 650 | 4 | |a Right ventricle insertion points | |
| 650 | 7 | |a Contrast Media |2 NLM | |
| 650 | 7 | |a Gadolinium |2 NLM | |
| 650 | 7 | |a AU0V1LM3JT |2 NLM | |
| 700 | 1 | |a Abecasis, João |e verfasserin |4 aut | |
| 700 | 1 | |a Santos, Rita Reis |e verfasserin |4 aut | |
| 700 | 1 | |a Lopes, Pedro |e verfasserin |4 aut | |
| 700 | 1 | |a Oliveira, Luis |e verfasserin |4 aut | |
| 700 | 1 | |a Guerreiro, Sara |e verfasserin |4 aut | |
| 700 | 1 | |a Freitas, Pedro |e verfasserin |4 aut | |
| 700 | 1 | |a Ferreira, António |e verfasserin |4 aut | |
| 700 | 1 | |a Nolasco, Tiago |e verfasserin |4 aut | |
| 700 | 1 | |a Gil, Victor |e verfasserin |4 aut | |
| 700 | 1 | |a Cardim, Nuno |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t International journal of cardiology |d 1984 |g 378(2023) vom: 01. Mai, Seite 159-163 |w (DE-627)NLM012621196 |x 1874-1754 |7 nnns |
| 773 | 1 | 8 | |g volume:378 |g year:2023 |g day:01 |g month:05 |g pages:159-163 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.ijcard.2023.02.034 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 378 |j 2023 |b 01 |c 05 |h 159-163 | ||