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Multimodality Imaging Markers of Adverse Myocardial Remodeling in Aortic Stenosis

Treibel, TA; Badiani, S; Lloyd, G; Moon, JC; (2019) Multimodality Imaging Markers of Adverse Myocardial Remodeling in Aortic Stenosis. JACC: Cardiovascular Imaging , 12 (8) pp. 1532-1548. 10.1016/j.jcmg.2019.02.034. Green open access

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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.

Type: Article
Title: Multimodality Imaging Markers of Adverse Myocardial Remodeling in Aortic Stenosis
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.jcmg.2019.02.034
Publisher version: https://doi.org/10.1016/j.jcmg.2019.02.034
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: aortic stenosis, aortic valve replacement, myocardial hypertrophy, myocardial fibrosis
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Clinical Science
URI: https://discovery.ucl.ac.uk/id/eprint/10084758
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