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

Journal of Cardiovascular Magnetic Resonance

Research

Dae-Won Sohn¹  Hyung-Kwan Kim¹  Yong-Jin Kim¹  Seung-Pyo Lee¹  Yeon-Hyeon Choe²  Sung-Ji Park²  Sang-Chol Lee²  Sung-A Chang²  Seung Woo Park²  Whal Lee³  Eun-Ah Park³ 

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

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

DOI  :  10.1186/1532-429X-15-72

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

来源: Springer

【 摘 要 】

BackgroundSevere 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.Methods118 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.ResultsPatients 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).ConclusionsThese findings demonstrate the usefulness of CMR for early detection of subclinical LV structural and functional deterioration in AS patients.

【 授权许可】

Unknown   
© Lee et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.