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Cardiac magnetic resonance patterns of left ventricular remodeling in patients with severe aortic stenosis referred to surgical aortic valve replacement

2024-03Artigo científico Acesso aberto
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dc.contributor.authorReis Santos, Rita
dc.contributor.authorAbecasis, João
dc.contributor.authorAbecasis, João
dc.contributor.authorMaltês, Sérgio
dc.contributor.authorLopes, Pedro
dc.contributor.authorOliveira, Luís
dc.contributor.authorFreitas, Pedro
dc.contributor.authorFerreira, António
dc.contributor.authorRibeiras, Regina
dc.contributor.authorAndrade, Maria João
dc.contributor.authorSousa Uva, Miguel
dc.contributor.authorNeves, José Pedro
dc.contributor.authorGil, Victor
dc.contributor.authorCardim, Nuno
dc.contributor.authorCardim, Nuno
dc.contributor.institutionNOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
dc.contributor.pblNature Publishing Group
dc.date.accessioned2024-04-11T00:35:44Z
dc.date.available2024-04-11T00:35:44Z
dc.date.issued2024-03
dc.descriptionPublisher Copyright: © The Author(s) 2024.
dc.description.abstractLeft ventricular (LV) hypertrophy is a common finding in patients with severe aortic stenosis (AS). Cardiac magnetic resonance (CMR) is the gold-standard technique to evaluate LV remodeling. Our aim was to assess the prevalence and describe the patterns of LV adaptation in AS patients before and after surgical aortic valve replacement (AVR). Prospective study of 130 consecutive patients (71y [IQR 68–77y], 48% men) with severe AS, referred for surgical AVR. Patterns of LV remodeling were assessed by CMR. Besides normal LV ventricular structure, four other patterns were considered: concentric remodeling, concentric hypertrophy, eccentric hypertrophy, and adverse remodeling. At baseline CMR study: mean LV indexed mass: 81.8 ± 26.7 g/m2; mean end-diastolic LV indexed volume: 85.7 ± 23.1 mL/m2 and median geometric remodeling ratio: 0.96 g/mL [IQR 0.82–1.08 g/mL]. LV hypertrophy occurred in 49% of subjects (concentric 44%; eccentric 5%). Both normal LV structure and concentric remodeling had a prevalence of 25% among the cohort; one patient had an adverse remodeling pattern. Asymmetric LV wall thickening was present in 55% of the patients, with predominant septal involvement. AVR was performed in 119 patients. At 3–6 months after AVR, LV remodeling changed to: normal ventricular geometry in 60%, concentric remodeling in 27%, concentric hypertrophy in 10%, eccentric hypertrophy in 3% and adverse remodeling (one patient). Indexes of AS severity, LV systolic and diastolic function and NT-proBNP were significantly different among the distinct patterns of remodeling. Several distinct patterns of LV remodelling beyond concentric hypertrophy occur in patients with classical severe AS. Asymmetric hypertrophy is a common finding and LV response after AVR is diverse.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent2652447
dc.identifier.doi10.1038/s41598-024-56838-0
dc.identifier.issn2045-2322
dc.identifier.otherPURE: 87105803
dc.identifier.otherPURE UUID: 1a4f7c7c-8d30-4f04-a88b-256f149ca3d7
dc.identifier.otherScopus: 85188563567
dc.identifier.otherPubMed: 38528043
dc.identifier.otherWOS: 001191155200011
dc.identifier.urihttp://hdl.handle.net/10362/166073
dc.identifier.urlhttps://www.scopus.com/pages/publications/85188563567
dc.language.isoeng
dc.peerreviewedyes
dc.subjectAortic stenosis
dc.subjectCardiac magnetic resonance
dc.subjectLeft ventricular hypertrophy and remodeling
dc.subjectGeneral
dc.titleCardiac magnetic resonance patterns of left ventricular remodeling in patients with severe aortic stenosis referred to surgical aortic valve replacementen
dc.typejournal article
degois.publication.issue1
degois.publication.titleScientific Reports
degois.publication.volume14
dspace.entity.typePublication
person.familyNameVeiga Abecasis
person.familyNameCardim
person.givenNameJoão Maria
person.givenNameNuno
person.identifier.ciencia-idCE1A-F89F-4839
person.identifier.orcid0000-0002-4741-8178
person.identifier.orcid0000-0002-3812-4872
rcaap.rightsopenAccess
relation.isAuthorOfPublication89948e10-0ec1-4048-ae85-1fba7e16690f
relation.isAuthorOfPublicationbcbf3f33-253a-4b76-a55f-23e4caf28001
relation.isAuthorOfPublication.latestForDiscovery89948e10-0ec1-4048-ae85-1fba7e16690f

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