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Prognostic implications of fibrosis in low risk aortic stenosis patients

التفاصيل البيبلوغرافية
العنوان: Prognostic implications of fibrosis in low risk aortic stenosis patients
المؤلفون: Cristina Gavina, Inês Falcão-Pires, João Santos-Faria, Benjamim Marinho, Jorge Almeida, João Rodrigues, Paulo Pinho, Francisco Rocha-Gonçalves, Adelino Leite-Moreira
المصدر: Revista Portuguesa de Cardiologia, Vol 41, Iss 1, Pp 3-14 (2022)
بيانات النشر: Elsevier, 2022.
سنة النشر: 2022
المجموعة: LCC:Diseases of the circulatory (Cardiovascular) system
مصطلحات موضوعية: Estenose aórtica, Hipertrofia, Remodelagem do ventrículo esquerdo, Fibrose miocárdica, Substituição valvular aórtica, Diseases of the circulatory (Cardiovascular) system, RC666-701
الوصف: Introduction and objectives: Among patients with aortic stenosis (AS), interstitial fibrosis has been associated with progression to heart failure and is a marker of poorer prognosis. We aimed to assess the impact of myocardial fibrosis on clinical events after aortic valve replacement (AVR) in low risk, severe AS. Methods: We prospectively followed 56 severe AS patients with ejection fraction >40%, who underwent AVR with simultaneous myocardial biopsies and collagen volume fraction (CVF) determination. Baseline and follow-up echocardiographic parameters were assessed. Outcomes were all-cause death and the combined endpoint of all-cause death or non-fatal cardiovascular hospitalization. Results: Patients were predominantly women (67.9%) and mean age was 66±12 years. At follow-up, there was a significant decrease in transaortic gradients and wall stress, as well as regression in indexed LV mass. Patients who suffered a fatal event or the combined endpoint had a higher degree of fibrosis (27.1±20.7% vs. 15.4±11.8%, p=0.035; 24.0±18.2% vs. 15.3±12.0%, p=0.038, respectively). Patients with CVF≥15.4% had higher rates of all-cause death (37.5% vs. 97.0%, p=0.001) and lower survival free of the combined endpoint of all-cause death or non-fatal cardiovascular hospitalization (0% vs. 91.2%, p40% submetidos a SVA com biópsia simultânea do miocárdio e determinação da fração de volume de colagénio (FVC). Parâmetros ecocardiográficos no início e no seguimento foram avaliados. Os outcomes estudados foram mortalidade por todas as causas e o evento combinado de mortalidade por todas as causas ou hospitalização cardiovascular não fatal. Resultados: Os doentes eram predominantemente mulheres (67,9%) e a idade média foi 66±12 anos. No follow-up, houve uma diminuição significativa do gradiente transaórtico e do stress da parede, assim como regressão da massa indexada do VE. Os doentes que sofreram um evento fatal ou o evento combinado tinham um maior grau de fibrose (27,1±20,7% versus 15,4±11,8%, p=0,035; 24,0±18,2% versus 15,3±12,0%, p=0,038, respetivamente). Os pacientes com FVC≥15,4% tiveram pior sobrevida (37,5% versus 97,0%, p=0,001) e menor sobrevivência livre do evento combinado (0% versus 91,2%, p
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
Portuguese
تدمد: 0870-2551
Relation: http://www.sciencedirect.com/science/article/pii/S0870255121004546; https://doaj.org/toc/0870-2551
DOI: 10.1016/j.repc.2021.02.017
URL الوصول: https://doaj.org/article/0f34a7f648134ffe816fd0bd86e219a0
رقم الأكسشن: edsdoj.0f34a7f648134ffe816fd0bd86e219a0
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:08702551
DOI:10.1016/j.repc.2021.02.017