Valvular & structural heart disease
Histopathological myocardial changes in patients with severe aortic stenosis referred for surgical valve replacement: a cardiac magnetic resonance correlation study
Authors' conclusion
Patients with severe symptomatic AS referred for surgical AVR have unspecific histological myocardial changes, including signs of cardiomyocyte ischaemic insult. ECM remodelling is ongoing, with MF heterogeneity.
Study context
- Population
- Patients with severe symptomatic aortic stenosis (AS) referred for surgical aortic valve replacement (AVR), with pre-operative cardiac magnetic resonance (CMR) and intra-operative septal endomyocardial biopsy129 with endomyocardial biopsy (EMB)
- Participants
- 158 patients
- Outcome
- Histopathological changes at endomyocardial biopsy and their correlation with CMR left ventricular (LV) tissue characterization
Main finding
As reported in the abstract
- Myocardial fibrosis at EMB, median (IQR)
- 11.9% (6.54-19.97)
- Predominant type I collagen perivascular distribution
- 95.3%
- Sub-endocardial cardiomyocyte ischaemic-like changes at EMB
- 45%
- Myocardial fibrosis (MF) at EMB correlated with late gadolinium enhancement (LGE) mass
- P = 0.008
- MF at EMB not correlated with global ECV
- P = 0.125
Observational data: associations, not effects.
Further findings
CMR tissue characterization · pre-operative
- Non-ischaemic LGE present
- 106 patients (67.1%)
- LGE median fraction
- 5.0% (2.0-9.7)
- Native T1 above normal
- 1053 ms (1024-1071)
- T2 within normal range
- 39.3 ms (37.3-42.0)
- CMR n = 143
Original publication
Histopathological myocardial changes in patients with severe aortic stenosis referred for surgical valve replacement: a cardiac magnetic resonance correlation study. Eur Heart J Cardiovasc Imaging. Published 21 January 2024. doi:10.
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