Detection of Cardiac Fibrosis and Cell Death in Patients With Aortic Stenosis

Vesey, Alex; Esson, Gavin A; Chin, Calvin Woon Loong; Dweck, Marc R; Newby, David E.

doi:10.1016/s0735-1097(15)61190-1

Cited by 4 publications

(1 citation statement)

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“…Any rise in LV end diastolic pressure or fall in AVA has a deleterious effect on coronary supply, 35,46 and there is a strong association between ventricular load (measured by LV rate-pressure product) and decreased CFR, particularly affecting the subendocardium. 46 Stuttering ischemia yields subclinical LV dysfunction and apoptosis, which is linked with myocardial fibrosis 165 —an independent predictor of mortality. 116…”

Section: Clinical Implications Of Impaired Coronary Flowmentioning

confidence: 99%

Coronary Microcirculation in Aortic Stenosis

McConkey

Marber

Chiribiri

et al. 2019

Circ: Cardiovascular Interventions

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Section: Clinical Implications Of Impaired Coronary Flowmentioning

confidence: 99%

Coronary Microcirculation in Aortic Stenosis

McConkey

Marber

Chiribiri

et al. 2019

Circ: Cardiovascular Interventions

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Cardiac magnetic resonance T1 and extracellular volume mapping with motion correction and co-registration based on fast elastic image registration

Zhang

Kabus

et al. 2017

Magn Reson Mater Phy

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ObjectiveOur aim was to investigate the technical feasibility of a novel motion compensation method for cardiac magntic resonance (MR) T1 and extracellular volume fraction (ECV) mapping.Materials and methodsNative and post-contrast T1 maps were obtained using modified look-locker inversion recovery (MOLLI) pulse sequences with acquisition scheme defined in seconds. A nonrigid, nonparametric, fast elastic registration method was applied to generate motion-corrected T1 maps and subsequently ECV maps. Qualitative rating was performed based on T1 fitting-error maps and overlay images. Local deformation vector fields were produced for quantitative assessment. Intra- and inter-observer reproducibility were compared with and without motion compensation.ResultsEighty-two T1 and 39 ECV maps were obtained in 21 patients with diverse myocardial diseases. Approximately 60% demonstrated clear quality improvement after motion correction for T1 mapping, particularly for the poor-rating cases (23% before vs 2% after). Approximately 67% showed further improvement with co-registration in ECV mapping. Although T1 and ECV values were not clinically significantly different before and after motion compensation, there was improved intra- and inter-observer reproducibility after motion compensation.ConclusionsAutomated motion correction and co-registration improved the qualitative assessment and reproducibility of cardiac MR T1 and ECV measurements, allowing for more reliable ECV mapping.Electronic supplementary materialThe online version of this article (10.1007/s10334-017-0668-2) contains supplementary material, which is available to authorized users.

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Long-term prognostic impact of paravalvular leakage on coronary artery disease requires patient-specific quantification of hemodynamics

Khodaei

Garber

Bauer

et al. 2022

Sci Rep

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Transcatheter aortic valve replacement (TAVR) is a frequently used minimally invasive intervention for patient with aortic stenosis across a broad risk spectrum. While coronary artery disease (CAD) is present in approximately half of TAVR candidates, correlation of post-TAVR complications such as paravalvular leakage (PVL) or misalignment with CAD are not fully understood. For this purpose, we developed a multiscale computational framework based on a patient-specific lumped-parameter algorithm and a 3-D strongly-coupled fluid–structure interaction model to quantify metrics of global circulatory function, metrics of global cardiac function and local cardiac fluid dynamics in 6 patients. Based on our findings, PVL limits the benefits of TAVR and restricts coronary perfusion due to the lack of sufficient coronary blood flow during diastole phase (e.g., maximum coronary flow rate reduced by 21.73%, 21.43% and 21.43% in the left anterior descending (LAD), left circumflex (LCX) and right coronary artery (RCA) respectively (N = 6)). Moreover, PVL may increase the LV load (e.g., LV load increased by 17.57% (N = 6)) and decrease the coronary wall shear stress (e.g., maximum wall shear stress reduced by 20.62%, 21.92%, 22.28% and 25.66% in the left main coronary artery (LMCA), left anterior descending (LAD), left circumflex (LCX) and right coronary artery (RCA) respectively (N = 6)), which could promote atherosclerosis development through loss of the physiological flow-oriented alignment of endothelial cells. This study demonstrated that a rigorously developed personalized image-based computational framework can provide vital insights into underlying mechanics of TAVR and CAD interactions and assist in treatment planning and patient risk stratification in patients.

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Detection of Cardiac Fibrosis and Cell Death in Patients With Aortic Stenosis

Cited by 4 publications

References 0 publications

Coronary Microcirculation in Aortic Stenosis

Coronary Microcirculation in Aortic Stenosis

Cardiac magnetic resonance T1 and extracellular volume mapping with motion correction and co-registration based on fast elastic image registration

Long-term prognostic impact of paravalvular leakage on coronary artery disease requires patient-specific quantification of hemodynamics

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