Clinical impact of myocardial fibrosis in severe aortic stenosis
| Autor: | Linda Pagura, Giancarlo Vitrella, Renata Korcova, Alessandro Altinier, Matteo Castrichini, Cinzia Radesich, Antonio De Luca, Gianfranco Sinagra |
|---|---|
| Přispěvatelé: | Castrichini, Matteo, Vitrella, Giancarlo, De Luca, Antonio, Altinier, Alessandro, Korcova, Renata, Pagura, Linda, Radesich, Cinzia, Sinagra, Gianfranco |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Aortic stenosi Context (language use) Aortic stenosis LGE Magnetic resonance Myocardial fibrosis Left ventricular hypertrophy Cardiac magnetic resonance imaging Internal medicine medicine AcademicSubjects/MED00200 Pressure overload medicine.diagnostic_test business.industry Articles medicine.disease Stenosis Heart failure Aortic valve stenosis Cardiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | European Heart Journal Supplements : Journal of the European Society of Cardiology |
| ISSN: | 1554-2815 1520-765X |
| Popis: | The pressure overload due to the progressive narrowing of the valve area determines the development of the left ventricular hypertrophy which characterizes aortic stenosis (AS). The onset of myocardial fibrosis marks the inexorable decline of an initially compensatory response towards heart failure. However, myocardial fibrosis does not yet represent a key element in the prognostic and therapeutic framework of AS. In this context, cardiac magnetic resonance imaging plays a major role by highlighting both the focal irreversible fibrotic replacement, using the late gadolinium enhancement (LGE) technique, and the earlier diffuse reversible interstitial fibrosis, using the T1 mapping techniques. For this reason, the presence of myocardial fibrosis would be useful to identify a subgroup of patients at greater risk of events among the subjects with severe AS. Actually, more and more evidences seem to identify the presence of LGE as a powerful prognostic factor to be used to optimize the timing of prosthetic valve replacement. Randomized clinical trials, such as the EVoLVeD trial currently underway, will be needed to better define the importance of myocardial fibrosis assessment in the management of patients with AS. |
| Databáze: | OpenAIRE |
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