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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

Authors
 Junbeom Park  ;  Hyuk-Jae Chang  ;  Jung-Ho Choi  ;  Pil-Sung Yang  ;  Sang-Eun Lee  ;  Ran Heo  ;  Sanghoon Shin  ;  In-Jeong Cho  ;  Young-Jin Kim  ;  Chi Young Shim  ;  Geu-Ru Hong  ;  Namsik Chung 
Citation
 Korean Circulation Journal, Vol.44(05) : 312-319, 2014 
Journal Title
 Korean Circulation Journal 
ISSN
 1738-5520 
Issue Date
2014
Abstract
BACKGROUND AND OBJECTIVES: WE INVESTIGATED ECHOCARDIOGRAPHIC PREDICTORS: left ventricular (LV) geometric changes following aortic valve replacement (AVR) according to the late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging (CMR) in patients with severe aortic stenosis (AS) and preserved LV systolic function. SUBJECTS AND METHODS: We analyzed 41 patients (24 males, 63.1±8.7 years) with preserved LV systolic function who were scheduled to undergo AVR for severe AS. All patients were examined with transthoracic echocardiography (TTE), CMR before and after AVR (in the hospital) and serial TTEs (at 6 and 12 months) were repeated. RESULTS: The group with LGE (LGE+) showed greater wall thickness (septum, 14.3±2.6 mm vs. 11.5±2.0 mm, p=0.001, posterior; 14.3±2.5 mm vs. 11.4±1.6 mm, p<0.001), lower tissue Doppler image (TDIS', 4.4±1.4 cm/s vs. 5.5±1.2 cm/s, p=0.021; TDI E', 3.2±0.9 cm/s vs. 4.8±1.4 cm/s, p=0.002), and greater E/e' (21.8±10.3 vs. 15.4±6.3, p=0.066) than those without LGE (LGE-). Multivariate analysis show that TDI e' (odds ratio=0.078, 95% confidence interval=0.007-0.888, p=0.040) was an independent determinant of LGE+. In an analysis of the 6- and 12-month follow-up compared with pre-AVR, LGE- showed decreased LV end-diastolic diameter (48.3±5.0 mm vs. 45.8±3.6 mm, p=0.027; 48.3±5.0 mm vs. 46.5±3.4 mm, p=0.019). Moreover, E/e' (at 12 months) showed further improved LV filling pressure (16.0±6.6 vs. 12.3±4.3, p=0.001) compared with pre-AVR. However, LGE+ showed no significant improvement. CONCLUSION: The absence of LGE is associated with favorable improvements in LV geometry and filling pressure. TDI E' is an independent determinant of LGE in patients with severe AS and preserved LV systolic function.
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T201403636.pdf Download
DOI
10.4070/kcj.2014.44.5.312
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
김영진(Kim, Young Jin) ORCID logo https://orcid.org/0000-0002-6235-6550
박준범(Park, Jun Beom)
신상훈(Shin, Sang Hoon)
심지영(Shim, Chi Young) ORCID logo https://orcid.org/0000-0002-6136-0136
양필성(Yang, Pil Sung)
이상은(Lee, Sang Eun) ORCID logo https://orcid.org/0000-0001-6645-4038
장혁재(Chang, Hyuck Jae) ORCID logo https://orcid.org/0000-0002-6139-7545
정남식(Chung, Nam Sik)
조인정(Cho, In Jeong)
최정호(Choi, Jung Ho)
허란(Heo, Ran)
홍그루(Hong, Geu Ru) ORCID logo https://orcid.org/0000-0003-4981-3304
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/100102
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