Incomplete recovery of myocardial remodeling after aortic valve replacement for isolated stenosis: The importance of fibrosis.

• Type: Summary of Presentation in a National Conference
• Date: 2009

Authors

Gavina C (Author) FMUP; Falcão-Pires I (Author) FMUP; Lopes R (Author) Other; Azevedo A (Author) FMUP; Pinho P (Author) Other; Júlia-Maciel M (Author) FMUP; Rocha Gonçalves F (Author) FMUP; Leite-Moreira AF (Author) FMUP

Conference proceedings National

Title: Revista Portuguesa Cardiologia

Initial page: I-29

XXX Congresso Português de Cardiologia

Vilamoura, 19 a 22 de Abril de 2009

Scientific classification

FOS: Medical and Health sciences > Other medical sciences

CORDIS: Health sciences > Medical sciences > Medicine > Cardiology

Other information

Resumo (PT): Objective: Some patients with isolated aortic stenosis (AS) have irreversible changes of left ventricular hypertrophy and ventricular filling after valve replacement. Our aim was to determine if fibrosis was a determinant of this negative remodeling. Methods: Prospective study of 11 pts with isolated AS undergoing aortic valve replacement (AVR). Exclusion criteria: other significant valve lesions (>mild), significant coronary artery disease (>50%), atrial fibrillation. Demographic, clinical and echocardiographic data were analyzed before surgery and 6 months after. The percentage of interstitial fibrosis was determined from myocardial biopsies collected during surgery, after patient consent. Continuous variables were summarized as median (interquartile range (P25-75)). The association between continuous variables was quantified using Spearman’s correlation. Results: In this sample 6 patients were male, median age 70.0 years (P25-75: 63.0- 74.0 years), 2 had history of hypertension and 2 had diabetes mellitus (DM), 9 were in NYHA class I/II and 2 in class III. Median relative mass regression after AVR was 16.6% (P25-75:3.2-27.5). Median percentage of interstitial fibrosis was 11.5% (P25-75:10.7- 12.7). Higher percentage of fibrosis was related with higher left ventricular mass index (rho=0.63, p=0.04) and abnormal relative wall thickness (14.1 (11.8-18.2) vs 10.8 (7.7-11.5) if normal relative wall thickness, p=0.02) at 6 months, with no differences before surgery. Conclusions: Our results suggest that, in patients with isolated aortic stenosis, a smaller regression of concentric hypertrophy is attributable to higher levels of fibrosis. These results need to be confirmed in larger samples. Still, they open pathways for the investigation of new treatments for diastolic dysfunction in aortic stenosis.

Language: Portuguese

Type (Professor's evaluation): Scientific

Notes: XXX Congresso Português de Cardiologia, publicado na Rev. Port. Cardiol. 2009; Vol.28(Supl.I):I-29.