Diffuse Myocardial Fibrosis and Diastolic Function in Aortic Stenosis
Diffuse Myocardial Fibrosis and Diastolic Function in Aortic Stenosis
复制标题
主动脉瓣狭窄的弥漫性心肌纤维化与舒张功能
DOI：
10.1016/j.jcmg.2020.07.007
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发表时间：
2020-12-01
影响因子：
14
通讯作者：
Lee, Seung-Pyo
中科院分区：
文献类型：
--
作者：
Lee, Hyun-Jung;Lee, Heesun;Lee, Seung-Pyo
本研究的目的是探讨细胞外容积分数（ECV）与主动脉瓣狭窄（AS）患者左心室舒张功能障碍（LVDD）之间的关系，ECV是一种非侵入性参数，可量化心脏磁共振（CMR）上弥漫性心肌纤维化的程度。然而，有一个非侵入性量化的弥漫性心肌纤维化和LVDD的程度之间的关联，以及如何这些都与AS患者的症状和长期预后的数据匮乏。方法中度或重度AS患者（n = 191;平均年龄68.4岁）和30名对照组无心血管危险因素进行CMR。根据2016年美国超声心动图学会/欧洲心血管成像协会指南，使用超声心动图评价LVDD等级。临床结果被定义为一个复合的全因死亡率或住院治疗心力衰竭aggregation.Results患者在较高的ECV五分位数有一个显着较高的患病率LVDD。较高的ECV尤其与心肌舒张功能降低相关（室间隔舒张功能降低）。
OBJECTIVES The aim of this study was to investigate the relationship between extracellular volume fraction (ECV), a noninvasive parameter that quantifies the degree of diffuse myocardial fibrosis on cardiac magnetic resonance (CMR), and left ventricular diastolic dysfunction (LVDD) in patients with aortic stenosis (AS).BACKGROUND Myocardial fibrosis on invasive myocardial biopsy is associated with LVDD. However, there is a paucity of data on the association between noninvasively quantified diffuse myocardial fibrosis and the degree of LVDD and how these are related to symptoms and long-term prognosis in patients with AS.METHODS Patients with moderate or severe AS (n = 191; mean age 68.4 years) and 30 control subjects without cardiovascular risk factors underwent CMR. LVDD grade was evaluated using echocardiography according to the 2016 American Society of Echocardiography/European Association of Cardiovascular Imaging guidelines. Clinical outcomes were defined as a composite of all-cause mortality or hospitalization for heart failure aggravation.RESULTS Patients in higher ECV quintiles had a significantly higher prevalence of LVDD. Higher ECV was particularly associated with decreased myocardial relaxation (septal e'