A model based on clinical parameters to identify myocardial late gadolinium enhancement by magnetic resonance in patients with aortic stenosis: An observational study
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Published version
Author(s)
Type
Journal Article
Abstract
Objective: With increasing age, the prevalence of aortic stenosis grows exponentially, increasing left heart pressures and potentially leading to myocardial hypertrophy, myocardial fibrosis and adverse outcomes. To identify patients who are at greatest risk, an outpatient model for risk stratification would be of value to better direct patient imaging, frequency of monitoring and expeditious management of aortic stenosis with possible earlier surgical intervention. In this study, a relatively simple model is proposed to identify myocardial fibrosis in patients with a diagnosis of moderate or severe aortic stenosis. Design: Patients with moderate to severe aortic stenosis were enrolled into the study; patient characteristics, blood work, medications as well as transthoracic echocardiography and cardiovascular magnetic resonance were used to determine potential identifiers of myocardial fibrosis. Setting: The Royal Brompton Hospital, London, UK. Participants: One hundred and thirteen patients in derivation cohort and 26 patients in validation cohort. Main outcome measures: Identification of myocardial fibrosis. Results: Three blood biomarkers (serum platelets, serum urea, N-terminal pro-B-type natriuretic peptide) and left ventricular ejection fraction were shown to be capable of identifying myocardial fibrosis. The model was validated in a separate cohort of 26 patients. Conclusions: Although further external validation of the model is necessary prior to its use in clinical practice, the proposed clinical model may direct patient care with respect to earlier magnetic resonance imagining, frequency of monitoring and may help in risk stratification for surgical intervention for myocardial fibrosis in patients with aortic stenosis.
Date Issued
2020-04-27
Date Acceptance
2020-04-02
Citation
JRSM Cardiovascular Disease, 2020, 9, pp.2048004020922400-2048004020922400
ISSN
2048-0040
Publisher
SAGE Publications Ltd
Start Page
2048004020922400
End Page
2048004020922400
Journal / Book Title
JRSM Cardiovascular Disease
Volume
9
Copyright Statement
© The Author(s) 2020. This article is distributed under the terms of the Creative Commons AttributionNonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.
sagepub.com/en-us/nam/open-access-at-sage).
sagepub.com/en-us/nam/open-access-at-sage).
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/32426125
PII: 10.1177_2048004020922400
Subjects
Aortic stenosis
biomarkers
clinical model
left ventricular ejection fraction
magnetic resonance
myocardial fibrosis
Publication Status
Published
Coverage Spatial
England
Date Publish Online
2020-04-27