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Prognostic Significance of Myocardial Fibrosis Quantification by Histopathology and Magnetic Resonance Imaging in Patients With Severe Aortic Valve Disease

Azevedo, Clerio F., MD ; Nigri, Marcelo, MD ; Higuchi, Maria L., MD ; Pomerantzeff, Pablo M., MD ; Spina, Guilherme S., MD ; Sampaio, Roney O., MD ; Tarasoutchi, Flávio, MD ; Grinberg, Max, MD ; Rochitte, Carlos Eduardo, MD

Journal of the American College of Cardiology, 2010-07, Vol.56 (4), p.278-287 [Periódico revisado por pares]

New York, NY: Elsevier Inc

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Título:
Prognostic Significance of Myocardial Fibrosis Quantification by Histopathology and Magnetic Resonance Imaging in Patients With Severe Aortic Valve Disease
Autor: Azevedo, Clerio F., MD ; Nigri, Marcelo, MD ; Higuchi, Maria L., MD ; Pomerantzeff, Pablo M., MD ; Spina, Guilherme S., MD ; Sampaio, Roney O., MD ; Tarasoutchi, Flávio, MD ; Grinberg, Max, MD ; Rochitte, Carlos Eduardo, MD
Assuntos: Adult ; Age ; aortic valve disease ; Aortic Valve Stenosis - complications ; Aortic Valve Stenosis - pathology ; Aortic Valve Stenosis - physiopathology ; Biological and medical sciences ; Cardiology ; Cardiology. Vascular system ; Cardiovascular ; Cardiovascular disease ; Coronary vessels ; Endocardial and cardiac valvular diseases ; Female ; Fibrosis - etiology ; Heart ; Heart attacks ; histopathology ; Humans ; Internal Medicine ; magnetic resonance imaging ; Magnetic Resonance Imaging - methods ; Magnetic Resonance Imaging - standards ; Male ; Medical sciences ; Middle Aged ; myocardial fibrosis ; Myocardium - pathology ; NMR ; Nuclear magnetic resonance ; Prognosis ; Prospective Studies ; Severity of Illness Index ; Young Adult
É parte de: Journal of the American College of Cardiology, 2010-07, Vol.56 (4), p.278-287
Notas: ObjectType-Article-1
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Descrição: Objectives We sought to determine whether the quantitative assessment of myocardial fibrosis (MF), either by histopathology or by contrast-enhanced magnetic resonance imaging (ce-MRI), could help predict long-term survival after aortic valve replacement. Background Severe aortic valve disease is characterized by progressive accumulation of interstitial MF. Methods Fifty-four patients scheduled to undergo aortic valve replacement were examined by ce-MRI. Delayed-enhanced images were used for the quantitative assessment of MF. In addition, interstitial MF was quantified by histological analysis of myocardial samples obtained during open-heart surgery and stained with picrosirius red. The ce-MRI study was repeated 27 ± 22 months after surgery to assess left ventricular functional improvement, and all patients were followed for 52 ± 17 months to evaluate long-term survival. Results There was a good correlation between the amount of MF measured by histopathology and by ce-MRI (r = 0.69, p < 0.001). In addition, the amount of MF demonstrated a significant inverse correlation with the degree of left ventricular functional improvement after surgery (r = −0.42, p = 0.04 for histopathology; r = −0.47, p = 0.02 for ce-MRI). Kaplan-Meier analyses revealed that higher degrees of MF accumulation were associated with worse long-term survival (chi-square = 6.32, p = 0.01 for histopathology; chi-square = 5.85, p = 0.02 for ce-MRI). On multivariate Cox regression analyses, patient age and the amount of MF were found to be independent predictors of all-cause mortality. Conclusions The amount of MF, either by histopathology or by ce-MRI, is associated with the degree of left ventricular functional improvement and all-cause mortality late after aortic valve replacement in patients with severe aortic valve disease.
Editor: New York, NY: Elsevier Inc
Idioma: Inglês

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Prognostic Significance of Myocardial Fibrosis Quantification by Histopathology and Magnetic Resonance Imaging in Patients With Severe Aortic Valve Disease

Azevedo, Clerio F., MD ; Nigri, Marcelo, MD ; Higuchi, Maria L., MD ; Pomerantzeff, Pablo M., MD ; Spina, Guilherme S., MD ; Sampaio, Roney O., MD ; Tarasoutchi, Flávio, MD ; Grinberg, Max, MD ; Rochitte, Carlos Eduardo, MD

New York, NY: Elsevier Inc

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