Multimodality Imaging Markers of Adverse Myocardial Remodeling in Aortic Stenosis

JACC. Cardiovascular Imaging
Thomas A TreibelJames C Moon

Abstract

Aortic stenosis (AS) causes left ventricular remodeling (hypertrophy, remodeling, fibrosis) and other cardiac changes (left atrial dilatation, pulmonary artery and right ventricular changes). These changes, and whether they are reversible (reverse remodeling), are major determinants of timing and outcome from transcatheter or surgical aortic valve replacement. Cardiac changes in response to AS afterload can either be adaptive and reversible, or maladaptive and irreversible, when they may convey residual risk after intervention. Structural and hemodynamic assessment of AS therefore needs to evaluate more than the valve, and, in particular, the myocardial remodeling response. Imaging plays a key role in this. This review assesses how multimodality imaging evaluates AS myocardial hypertrophy and its components (cellular hypertrophy, fibrosis, microvascular changes, and additional features such as cardiac amyloid) both before and after intervention, and seeks to highlight how care and outcomes in AS could be improved.

Citations

Oct 28, 2019·Heart·Rong Bing, Marc Richard Dweck
May 27, 2020·Journal of the American Heart Association·Amgad Mentias, Hani Jneid
Dec 22, 2020·Frontiers in Cardiovascular Medicine·Ezequiel GuzzettiMarie-Annick Clavel
Feb 16, 2021·Current Problems in Cardiology·João AbecasisAna Félix
May 14, 2021·Circulation·Gautam R ShroffUNKNOWN American Heart Association Council on the Kidney in Cardiovascular Disease and Stroke Council
Aug 21, 2021·The Annals of Thoracic Surgery·Vivek PatelErnesto Jimenez

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiac Amyloidosis

Cardiac amyloidosis is a myocardial disease characterized by extracellular amyloid infiltration throughout the heart. Discover the latest research on cardiac amyloidosis here.

Cardiac Remodeling

Cardiac remodeling in response to a myocardial infarction is characterized by progressive ventricular dilatation, cardiac hypertrophy, fibrosis, and deterioration of cardiac performance. Discover the latest research on Cardiac Remodeling here.