Late Gadolinium Enhancement Predicts Improvement in Global Longitudinal Strain after Aortic Valve Replacement in Aortic Stenosis

Figure 1. Measurement of LGE by MRI. LGEcore, LGEgray, and LGEcore+gray were calculated as areas with the above-threshold signal intensity in the ROI (≥5 SD for LGEcore and 2–5 SD for LGEgray compared to the normal area). ROI: region of interest. LGE: late gadolinium enhancement.

Figure 2. Correlation between GLS, LGE and FI. (A) GLS was significantly correlated with LGEcore (g) (r2 = 0.14, p < 0.05), LGEgray (g) (r2 = 0.32, p < 0.01) and LGEcore+gray (g) (r2 = 0.36, p < 0.01). (B) LGEcore (g) (r2 = 0.38, p < 0.05) and LGEcore+gray (g) (r2 = 0.37, p < 0.05), but not LGEgray, was significantly correlated with the fibrosis index. (C) GLS was significantly correlated with the fibrosis index (r2 = 0.46, p < 0.05).

Figure 3. Receiver-Operating Characteristics (ROC) Curve Analysis for Prediction of GLS Improvement after AVR. (A) In the ROC analysis, the area under the curve was 0.81 for predicting postoperative GLS improvement (≥−19.9%) by LGEcore, with a cut-off value of 2.86 g (sensitivity, 78.6%; specificity, 83.3%). (B) Patients with low LGEcore (<2.86 g) showed improvement in GLS after AVR compared to those with high LGEcore (≥2.86 g). Black circle: LGEcore <2.86 g, white circle: LGEcore ≥2.86 g.