Late Gadolinium Enhancement in Cardiac MRI in Patients with Severe Aortic Stenosis and Preserved Left Ventricular Systolic Function Is Related to Attenuated Improvement of Left Ventricular Geometry and Filling Pressure after Aortic Valve Replacement
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Key result
The presence of late gadolinium enhancement on cardiac MRI is associated with attenuated improvement of left ventricular geometry and filling pressure after aortic valve replacement, with tissue Doppler imaging e' serving as an independent predictor (OR 0.078).
Why the study?
Does the presence of late gadolinium enhancement on cardiac MRI predict attenuated improvement in left ventricular geometry and filling pressure after aortic valve replacement in patients with severe aortic stenosis?
Population
41 patients with severe aortic stenosis and preserved left ventricular systolic function scheduled to…
Comparison
Presence of late gadolinium enhancement on… vs Absence of late gadolinium enhancement on…
Design
Cohort
Follow-up
12 months
Authors
Discussion
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Member takes
Implication
LGE on CMR may identify limited post-AVR remodeling in severe AS; hypothesis-generating for CMR-guided decisions pending prospective trials.
Study Design
Type
Cohort (n=41)
Multicenter
No
Structured PICO
Does the presence of late gadolinium enhancement on cardiac MRI predict attenuated improvement in left ventricular geometry and filling pressure after aortic valve replacement in patients with severe aortic stenosis?
P
Population
41 patients with severe aortic stenosis and preserved left ventricular systolic function scheduled for aortic valve replacement, followed for 12 months.
E
Exposure
Presence of late gadolinium enhancement (LGE+) on cardiac magnetic resonance imaging
C
Comparator
Absence of late gadolinium enhancement (LGE-) on cardiac magnetic resonance imaging
O
Outcome
Left ventricular geometric changes and filling pressure (including LV end-diastolic diameter and E/e') at 6 and 12 months post-aortic valve replacementsurrogate
Main Result
Odds Ratio: 0.078 (95% CI 0.007–0.888)
p-value: p=0.040
The presence of late gadolinium enhancement on cardiac MRI in patients with severe aortic stenosis predicts a lack of favorable left ventricular reverse remodeling and filling pressure improvement after aortic valve replacement.
Limitations
- Did not evaluate differences according to the degree or severity of LGE.
- No mortality occurred during the 12-month follow-up, precluding analysis of mortality outcomes.
- Small sample size.
Cite This Study
Park et al. (2014) conducted a cohort in Severe aortic stenosis with preserved left ventricular systolic function (n=41). Late gadolinium enhancement (LGE) vs. Absence of LGE was evaluated on Presence of late gadolinium enhancement (LGE+) predicted by tissue Doppler imaging e' (OR 0.078, 95% CI 0.007-0.888, p=0.040). The presence of late gadolinium enhancement on cardiac MRI is associated with attenuated improvement of left ventricular geometry and filling pressure after aortic valve replacement, with tissue Doppler imaging e' serving as an independent predictor (OR 0.078).
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