Document Detail


Prognostic significance of myocardial fibrosis quantification by histopathology and magnetic resonance imaging in patients with severe aortic valve disease.
MedLine Citation:
PMID:  20633819     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We sought to determine whether the quantitative assessment of myocardial fibrosis (MF), either by histopathology or by contrast-enhanced magnetic resonance imaging (ce-MRI), could help predict long-term survival after aortic valve replacement. BACKGROUND: Severe aortic valve disease is characterized by progressive accumulation of interstitial MF. METHODS: Fifty-four patients scheduled to undergo aortic valve replacement were examined by ce-MRI. Delayed-enhanced images were used for the quantitative assessment of MF. In addition, interstitial MF was quantified by histological analysis of myocardial samples obtained during open-heart surgery and stained with picrosirius red. The ce-MRI study was repeated 27+/-22 months after surgery to assess left ventricular functional improvement, and all patients were followed for 52+/-17 months to evaluate long-term survival. RESULTS: There was a good correlation between the amount of MF measured by histopathology and by ce-MRI (r=0.69, p<0.001). In addition, the amount of MF demonstrated a significant inverse correlation with the degree of left ventricular functional improvement after surgery (r=-0.42, p=0.04 for histopathology; r=-0.47, p=0.02 for ce-MRI). Kaplan-Meier analyses revealed that higher degrees of MF accumulation were associated with worse long-term survival (chi-square=6.32, p=0.01 for histopathology; chi-square=5.85, p=0.02 for ce-MRI). On multivariate Cox regression analyses, patient age and the amount of MF were found to be independent predictors of all-cause mortality. CONCLUSIONS: The amount of MF, either by histopathology or by ce-MRI, is associated with the degree of left ventricular functional improvement and all-cause mortality late after aortic valve replacement in patients with severe aortic valve disease.
Authors:
Clerio F Azevedo; Marcelo Nigri; Maria L Higuchi; Pablo M Pomerantzeff; Guilherme S Spina; Roney O Sampaio; Flávio Tarasoutchi; Max Grinberg; Carlos Eduardo Rochitte
Related Documents :
7568809 - Blunt traumatic aortic rupture: detection with helical ct of the chest.
15956499 - Ct angiography with electrocardiographically gated reconstruction for visualizing pulsa...
2273629 - Pseudocoarctation of the aorta--a case report.
20617089 - Distinction between intradural and extradural aneurysms involving the paraclinoid inter...
15221049 - Intravascular papillary endothelial hyperplasia in an intracranial thrombosed aneurysm:...
16738839 - Echocardiographic findings mimicking type a aortic dissection.
19410029 - Ability of dgemric and t2 mapping to evaluate cartilage repair after microfracture: a g...
22561339 - Dual-purpose magnetic micelles for mri and gene delivery.
19820949 - Dynamic contrast-enhanced mr imaging to assess physiologic variations of myometrial per...
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  56     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-16     Completed Date:  2010-08-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  278-87     Citation Subset:  AIM; IM    
Copyright Information:
Copyright (c) 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Affiliation:
Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aortic Valve Stenosis / complications,  pathology*,  physiopathology
Female
Fibrosis / etiology
Humans
Magnetic Resonance Imaging / methods*,  standards
Male
Middle Aged
Myocardium / pathology*
Prognosis
Prospective Studies
Severity of Illness Index*
Young Adult
Comments/Corrections
Comment In:
J Am Coll Cardiol. 2010 Jul 20;56(4):288-9   [PMID:  20633820 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Value of the SYNTAX Score for Risk Assessment in the All-Comers Population of the Randomized Multice...
Next Document:  Iodofiltic Acid I 123 (BMIPP) Fatty Acid Imaging Improves Initial Diagnosis in Emergency Department ...