PMID- 29914867
OWN - NLM
STAT- MEDLINE
DCOM- 20190812
LR  - 20220129
IS  - 1942-0080 (Electronic)
IS  - 1941-9651 (Print)
IS  - 1941-9651 (Linking)
VI  - 11
IP  - 6
DP  - 2018 Jun
TI  - Progression of Hypertrophy and Myocardial Fibrosis in Aortic Stenosis: A 
      Multicenter Cardiac Magnetic Resonance Study.
PG  - e007451
LID - 10.1161/CIRCIMAGING.117.007451 [doi]
AB  - BACKGROUND: Aortic stenosis is accompanied by progressive left ventricular 
      hypertrophy and fibrosis. We investigated the natural history of these processes 
      in asymptomatic patients and their potential reversal post-aortic valve 
      replacement (AVR). METHODS: Asymptomatic and symptomatic patients with aortic 
      stenosis underwent repeat echocardiography and magnetic resonance imaging. 
      Changes in peak aortic-jet velocity, left ventricular mass index, diffuse 
      fibrosis (indexed extracellular volume), and replacement fibrosis (late 
      gadolinium enhancement [LGE]) were quantified. RESULTS: In 61 asymptomatic 
      patients (43% mild, 34% moderate, and 23% severe aortic stenosis), significant 
      increases in peak aortic-jet velocity, left ventricular mass index, indexed 
      extracellular volume, and LGE mass were observed after 2.1+/-0.7 years, with the 
      most rapid progression observed in patients with most severe stenosis. Patients 
      with baseline midwall LGE (n=16 [26%]; LGE mass, 2.5 g [0.8-4.8 g]) demonstrated 
      particularly rapid increases in scar burden (78% [50%-158%] increase in LGE mass 
      per year). In 38 symptomatic patients (age, 66+/-8 years; 76% men) who underwent 
      AVR, there was a 19% (11%-25%) reduction in left ventricular mass index 
      (P<0.0001) and an 11% (4%-16%) reduction in indexed extracellular volume 
      (P=0.003) 0.9+/-0.3 years after surgery. By contrast midwall LGE (n=10 [26%]; mass, 
      3.3 g [2.6-8.0 g]) did not change post-AVR (n=10; 3.5 g [2.1-8.0 g]; P=0.23), 
      with no evidence of regression even out to 2 years. CONCLUSIONS: In patients with 
      aortic stenosis, cellular hypertrophy and diffuse fibrosis progress in a rapid 
      and balanced manner but are reversible after AVR. Once established, midwall LGE 
      also accumulates rapidly but is irreversible post valve replacement. Given its 
      adverse long-term prognosis, prompt AVR when midwall LGE is first identified may 
      improve clinical outcomes. CLINICAL TRIAL REGISTRATION: URL: 
      https://www.clinicaltrials.gov. Unique identifiers: NCT01755936 and NCT01679431.
CI  - (c) 2018 The Authors.
FAU - Everett, Russell J
AU  - Everett RJ
AD  - British Heart Foundation Centre for Cardiovascular Science (R.J.E., J.K., M.G., 
      E.J.R.v.B., C.W., S.S., D.E.N., M.R.D.) Russell.everett@ed.ac.uk.
FAU - Tastet, Lionel
AU  - Tastet L
AD  - University of Edinburgh, United Kingdom. Department of Medicine, Quebec Heart and 
      Lung Institute, Canada (L.T., M.-A.C., R.C., E.L., P.P.).
FAU - Clavel, Marie-Annick
AU  - Clavel MA
AD  - University of Edinburgh, United Kingdom. Department of Medicine, Quebec Heart and 
      Lung Institute, Canada (L.T., M.-A.C., R.C., E.L., P.P.).
FAU - Chin, Calvin W L
AU  - Chin CWL
AD  - Department of Cardiovascular Science, National Heart Center Singapore (C.W.L.C.).
FAU - Capoulade, Romain
AU  - Capoulade R
AD  - University of Edinburgh, United Kingdom. Department of Medicine, Quebec Heart and 
      Lung Institute, Canada (L.T., M.-A.C., R.C., E.L., P.P.).
FAU - Vassiliou, Vassilios S
AU  - Vassiliou VS
AD  - Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, London, United 
      Kingdom (V.S.V., S.K.P.).
AD  - Norwich Medical School, Norfolk and Norwich University Hospital, United Kingdom 
      (V.S.V.).
FAU - Kwiecinski, Jacek
AU  - Kwiecinski J
AD  - British Heart Foundation Centre for Cardiovascular Science (R.J.E., J.K., M.G., 
      E.J.R.v.B., C.W., S.S., D.E.N., M.R.D.).
AD  - First Department of Cardiology, Poznan University of Medical Sciences, Poland 
      (J.K.).
FAU - Gomez, Miquel
AU  - Gomez M
AD  - British Heart Foundation Centre for Cardiovascular Science (R.J.E., J.K., M.G., 
      E.J.R.v.B., C.W., S.S., D.E.N., M.R.D.).
AD  - Hospital del Mar Medical Research Institute, Universitat Pompeu Fabra, Barcelona, 
      Spain (M.G.).
FAU - van Beek, Edwin J R
AU  - van Beek EJR
AD  - British Heart Foundation Centre for Cardiovascular Science (R.J.E., J.K., M.G., 
      E.J.R.v.B., C.W., S.S., D.E.N., M.R.D.).
AD  - Edinburgh Imaging Queen's Medical Research Institute Facility (E.J.R.v.B., S.S.).
FAU - White, Audrey C
AU  - White AC
FAU - Prasad, Sanjay K
AU  - Prasad SK
AD  - Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, London, United 
      Kingdom (V.S.V., S.K.P.).
FAU - Larose, Eric
AU  - Larose E
AD  - University of Edinburgh, United Kingdom. Department of Medicine, Quebec Heart and 
      Lung Institute, Canada (L.T., M.-A.C., R.C., E.L., P.P.).
FAU - Tuck, Christopher
AU  - Tuck C
AD  - British Heart Foundation Centre for Cardiovascular Science (R.J.E., J.K., M.G., 
      E.J.R.v.B., C.W., S.S., D.E.N., M.R.D.).
AD  - Edinburgh Clinical Trials Unit, Usher Institute of Population Health Sciences and 
      Informatics (C.T.).
FAU - Semple, Scott
AU  - Semple S
AD  - British Heart Foundation Centre for Cardiovascular Science (R.J.E., J.K., M.G., 
      E.J.R.v.B., C.W., S.S., D.E.N., M.R.D.).
AD  - Edinburgh Imaging Queen's Medical Research Institute Facility (E.J.R.v.B., S.S.).
FAU - Newby, David E
AU  - Newby DE
AD  - British Heart Foundation Centre for Cardiovascular Science (R.J.E., J.K., M.G., 
      E.J.R.v.B., C.W., S.S., D.E.N., M.R.D.).
FAU - Pibarot, Philippe
AU  - Pibarot P
AD  - University of Edinburgh, United Kingdom. Department of Medicine, Quebec Heart and 
      Lung Institute, Canada (L.T., M.-A.C., R.C., E.L., P.P.).
FAU - Dweck, Marc R
AU  - Dweck MR
AD  - British Heart Foundation Centre for Cardiovascular Science (R.J.E., J.K., M.G., 
      E.J.R.v.B., C.W., S.S., D.E.N., M.R.D.).
LA  - eng
SI  - ClinicalTrials.gov/NCT01755936
SI  - ClinicalTrials.gov/NCT01679431
GR  - FDN-143225/CIHR/Canada
GR  - RE/13/3/30183/BHF_/British Heart Foundation/United Kingdom
GR  - FS/14/78/31020/BHF_/British Heart Foundation/United Kingdom
GR  - WT103782AIA/WT_/Wellcome Trust/United Kingdom
GR  - G0701127/MRC_/Medical Research Council/United Kingdom
GR  - CH/09/002/26360/BHF_/British Heart Foundation/United Kingdom
GR  - MOP-114997/CIHR/Canada
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Circ Cardiovasc Imaging
JT  - Circulation. Cardiovascular imaging
JID - 101479935
RN  - 0 (Contrast Media)
CIN - Circ Cardiovasc Imaging. 2018 Jun;11(6):e007975. PMID: 29914870
MH  - Aged
MH  - Aortic Valve Stenosis/complications/*diagnostic imaging/physiopathology/surgery
MH  - Contrast Media/administration & dosage
MH  - Disease Progression
MH  - Echocardiography
MH  - Female
MH  - Fibrosis
MH  - Heart Valve Prosthesis Implantation
MH  - Humans
MH  - Hypertrophy, Left Ventricular/*diagnostic 
      imaging/etiology/pathology/physiopathology
MH  - *Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Myocardium/*pathology
MH  - Predictive Value of Tests
MH  - Prospective Studies
MH  - Quebec
MH  - Scotland
MH  - Severity of Illness Index
MH  - Time Factors
MH  - *Ventricular Function, Left
MH  - *Ventricular Remodeling
PMC - PMC6023592
OTO - NOTNLM
OT  - aortic valve stenosis
OT  - fibrosis
OT  - gadolinium
OT  - hypertrophy
OT  - magnetic resonance imaging
EDAT- 2018/06/20 06:00
MHDA- 2019/08/14 06:00
PMCR- 2018/06/28
CRDT- 2018/06/20 06:00
PHST- 2017/12/10 00:00 [received]
PHST- 2018/04/23 00:00 [accepted]
PHST- 2018/06/20 06:00 [entrez]
PHST- 2018/06/20 06:00 [pubmed]
PHST- 2019/08/14 06:00 [medline]
PHST- 2018/06/28 00:00 [pmc-release]
AID - CIRCIMAGING.117.007451 [pii]
AID - 10.1161/CIRCIMAGING.117.007451 [doi]
PST - ppublish
SO  - Circ Cardiovasc Imaging. 2018 Jun;11(6):e007451. doi: 
      10.1161/CIRCIMAGING.117.007451.