Gewählte Publikation:

Sobota, V; Augustin, CM; Plank, G; Vigmond, EJ; Nordmeyer, S; Bayer, JD.
Increased extracellular volume after aortic valve replacement: A footprint of reverse ventricular remodeling that does not affect conduction velocity.
J Cardiovasc Magn Reson. 0; 27(2):101936 Doi: 10.1016/j.jocmr.2025.101936 [OPEN ACCESS]
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Co-Autor*innen der Med Uni Graz

Augustin Christoph

Plank Gernot

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Abstract:

BACKGROUND: Extracellular volume (ECV) determined by cardiovascular magnetic resonance (CMR) is considered a marker of diffuse myocardial fibrosis and a predictor of mortality. Using personalized computational models, we investigated the relationship between ECV, conduction velocity (CV), and cell radius in aortic stenosis (AS) patients. METHODS: CMR was performed on 12 AS patients (6 males, 6 females) before and three months after surgical aortic valve replacement (AVR). All patients had a QRS duration ≤110ms, and no scar on late gadolinium enhanced (LGE) CMR. Computational biventricular models were developed from each CMR dataset. Using patient-specific ECV and the relative change in cell radius between the time points as inputs, tissue conductivity was adjusted in each model to match the patient's QRS duration. A physiological pattern of ventricular depolarization was mimicked by simultaneously pacing each model from five activation sites. CV was measured during a simulation of apical pacing, using two points positioned at the right ventricular septum of the model. RESULTS: Left ventricular mass decreased after AVR (62 [58-79] vs 51 [41-60]g/m², p=0.0005) while ECV increased (24.2 [20.6-24.8] vs 28.0 [25.1-29.5] %, p=0.0008). No changes in the patient's QRS duration (89.0 [80.5-99.0] vs 88 [78.5-99.5]ms, p=0.2148) were observed. No changes in the CV obtained from the models (64.3 [61.9-72.8] vs 66.0 [60.0-74.5]cm/s, p=0.5186) were found between the time points, suggesting there was no substantial increase in diffuse fibrosis. ECV was negatively correlated with cell radius (r=-0.5267, p=0.0082), but not correlated with CV obtained from the models (r=-0.2036, p=0.3399). CONCLUSION: Increased ECV three months after AVR in patients with no LGE scar and with normal ventricular conduction appears to be a footprint of reverse ventricular remodeling that does not necessarily translate into changes in myocardial CV.

Find related publications in this database (using NLM MeSH Indexing)

Humans - administration & dosage

Male - administration & dosage

Female - administration & dosage

Ventricular Remodeling - administration & dosage

Aortic Valve Stenosis - surgery, physiopathology, diagnostic imaging, pathology

Aortic Valve - surgery, physiopathology, diagnostic imaging, pathology

Aged - administration & dosage

Heart Valve Prosthesis Implantation - adverse effects

Ventricular Function, Left - administration & dosage

Middle Aged - administration & dosage

Treatment Outcome - administration & dosage

Time Factors - administration & dosage

Models, Cardiovascular - administration & dosage

Patient-Specific Modeling - administration & dosage

Recovery of Function - administration & dosage

Predictive Value of Tests - administration & dosage

Fibrosis - administration & dosage

Action Potentials - administration & dosage

Magnetic Resonance Imaging, Cine - administration & dosage

Heart Conduction System - physiopathology, diagnostic imaging

Myocardium - pathology

Cardiac Pacing, Artificial - administration & dosage

Find related publications in this database (Keywords)

Aortic stenosis

Cardiovascular magnetic resonance

Computer modeling and simulations

Conduction velocity

Diffuse fibrosis

Extracellular volume

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