Early detection of subclinical ventricular deterioration in aortic stenosis with cardiovascular magnetic resonance and echocardiography

Journal of Cardiovascular Magnetic Resonance

Yeon-Hyeon Choe¹  Dae-Won Sohn³  Seung Woo Park¹  Sang-Chol Lee¹  Whal Lee²  Hyung-Kwan Kim³  Eun-Ah Park²  Sung-A Chang¹  Yong-Jin Kim³  Sung-Ji Park¹  Seung-Pyo Lee³ 

[1] Cardiovascular Imaging Center, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul 135-710, Korea;Department of Radiology, Seoul National University College of Medicine, 101 Daehak-ro, Jongro-gu, Seoul 110-744, Korea;Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehak-ro, Jongro-gu, Seoul 110-744, Korea

关键词: Myocardial fibrosis;    Myocardial function;    Magnetic resonance imaging;    Ventricular remodeling;    Heart function;    Echocardiography;    Cardiovascular magnetic resonance;    Aortic stenosis;   

Others  :  812137
DOI  :  10.1186/1532-429X-15-72

 received in 2013-03-09, accepted in 2013-08-08,  发布年份 2013

【 摘 要 】

Background

Severe aortic stenosis (AS) patients with late gadolinium enhancement (LGE) on cardiovascular magnetic resonance (CMR) or left ventricular (LV) systolic dysfunction are known to have worse outcome. We aimed to investigate whether LGE on CMR would be useful in early detection of subclinical LV structural and functional derangements in AS patients.

Methods

118 patients with moderate to severe AS were prospectively enrolled. Echocardiography and CMR images were taken and the patients were divided into groups according to the presence/absence of LGE and of LV systolic dysfunction (LV ejection fraction (EF) <50%). The stiffness of LV was calculated based on Doppler and CMR measurements.

Results

Patients were grouped into either group 1, no LGE and normal LVEF, group 2, LGE but normal LVEF and group 3, LGE with depressed LVEF. There was a significant trend towards increasing LV volumes, worsening of LV diastolic function (E/e’, diastolic elastance), systolic function (end-systolic elastance) and LV hypertrophy between the three groups, which coincided with worsening functional capacity (all p-value < 0.001 for trend). Also, significant differences in the above parameters were noted between group 1 and 2 (E/e’, 14.6 ± 4.3 (mean ± standard deviation) in group 1 vs. 18.2 ± 9.4 in group 2; end-systolic elastance, 3.24 ± 2.31 in group 1 vs. 2.38 ± 1.16 in group 2, all p-value < 0.05). The amount of myocardial fibrosis on CMR correlated with parameters of diastolic (diastolic elastance, Spearman’s ρ = 0.256, p-value = 0.005) and systolic function (end-systolic elastance, Spearman’s ρ = -0.359, p-value < 0.001).

Conclusions

These findings demonstrate the usefulness of CMR for early detection of subclinical LV structural and functional deterioration in AS patients.

【 授权许可】

   
2013 Lee et al.; licensee BioMed Central Ltd.

【 图 表 】

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