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Diagnosis of myocardial fibrosis by magnetic resonance imaging (T1 mapping) and histopathological quantification in patients with severe aortic valve disease submitted to conventional surgery and its impact on prognosis

Abstract

Patients with aortic valve regurgitation or stenosis have myocardial hypertrophy mechanisms that include cellular stimuli capable of promoting the formation of diffuse fibrosis. The importance of cardiovascular magnetic resonance (CMR) in the evaluation of myocardial structure and function is already established. A new method for evaluating fibrosis by CMR, called T1 mapping, has been developed. It can quantify with better sensitivity the extracellular myocardial volume, which represents, when increased, the diffuse myocardial fibrosis, in this population. The primary objective of this study is to evaluate the prognostic value of the preoperative quantification of diffuse myocardial fibrosis using T1 mapping (by the quantification of the extracellular distribution volume - EDV) in patients with severe aortic valve disease submitted to surgical treatment. One hundred patients with severe aortic valve stenosis or regurgitation will be included, and will undertake CMR before surgery and 6 to 9 months after surgery. The CMR data will be compared to the pathology data, acquired by intraoperative biopsy. Patients will be followed for 5 years postoperatively, and then the correlation between preoperative quantification of diffuse myocardial fibrosis and overall mortality will be evaluated. (AU)

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