Late gadolinium enhancement as a potential marker of increased perioperative risk in aortic valve replacement

Cesare Quarto; Marc R. Dweck; Timothy Murigu; Sanjiv Joshi; Giovanni Melina; Emiliano Angeloni; Sanjay K. Prasad; John R. Pepper

doi:10.1093/icvts/ivs098

Late gadolinium enhancement as a potential marker of increased perioperative risk in aortic valve replacement

Cesare Quarto^*, Marc R. Dweck, Timothy Murigu, Sanjiv Joshi, Giovanni Melina, Emiliano Angeloni, Sanjay K. Prasad, John R. Pepper

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

OBJECTIVES: Risk assessment of patients with aortic stenosis (AS) undergoing aortic valve replacement (AVR) is challenging. We set out to determine the impact of myocardial late gadolinium enhancement (LGE), as detected by cardiovascular magnetic resonance (CMR), on postoperative outcomes following AVR.

METHODS: A prospective observational study was conducted on patients undergoing CMR using the LGE technique within 1 year of subsequent AVR. Patients were categorized into absent, mid-wall or infarct patterns of LGE by independent observers blinded to all clinical data, and data were collected with regard to 30-day mortality, major adverse cardiac and cerebrovascular events (MACCE) and postoperative complications.

RESULTS: A total of 63 patients were studied. Twenty-five patients had no LGE; 20 had mid-wall LGE and 18 had an infarct pattern. The incidence of MACCE, cerebrovascular accident (CVA) and heart block were significantly higher in the mid-wall group compared with the other two groups (MACCE: 25 vs. 0 vs. 5%, P = 0.014; CVA: 20 vs. 0 vs. 0%, P = 0.013; heart block: 30 vs. 4 vs. 12%, P = 0.050). Patients with no LGE had no 30-day MACCE events and no deaths up to 2 years of follow-up.

CONCLUSIONS: The myocardial LGE holds promise as a means of predicting risk prior to AVR for AS.

Original language	English
Pages (from-to)	45-50
Number of pages	6
Journal	Interactive cardiovascular and thoracic surgery
Volume	15
Issue number	1
DOIs	https://doi.org/10.1093/icvts/ivs098
Publication status	Published - Jul 2012
Event	25th Annual Meeting of the European-Association-for-Cardio-Thoracic-Surgery (EACTS) - Lisbon, Portugal Duration: 1 Oct 2011 → 5 Oct 2011

Keywords / Materials (for Non-textual outputs)

Risk assessment
CARDIOMYOPATHY
Myocardial fibrosis
PREDICTOR
Magnetic resonance
MORTALITY
MIDWALL FIBROSIS
Aortic valve stenosis
CARDIAC MAGNETIC-RESONANCE
STENOSIS
LEFT-VENTRICULAR HYPERTROPHY

Access to Document

10.1093/icvts/ivs098

http://icvts.oxfordjournals.org/content/15/1/45

Cite this

@article{9bf65da878e2464ba8974821e4cdf5b0,

title = "Late gadolinium enhancement as a potential marker of increased perioperative risk in aortic valve replacement",

abstract = "OBJECTIVES: Risk assessment of patients with aortic stenosis (AS) undergoing aortic valve replacement (AVR) is challenging. We set out to determine the impact of myocardial late gadolinium enhancement (LGE), as detected by cardiovascular magnetic resonance (CMR), on postoperative outcomes following AVR.METHODS: A prospective observational study was conducted on patients undergoing CMR using the LGE technique within 1 year of subsequent AVR. Patients were categorized into absent, mid-wall or infarct patterns of LGE by independent observers blinded to all clinical data, and data were collected with regard to 30-day mortality, major adverse cardiac and cerebrovascular events (MACCE) and postoperative complications.RESULTS: A total of 63 patients were studied. Twenty-five patients had no LGE; 20 had mid-wall LGE and 18 had an infarct pattern. The incidence of MACCE, cerebrovascular accident (CVA) and heart block were significantly higher in the mid-wall group compared with the other two groups (MACCE: 25 vs. 0 vs. 5\%, P = 0.014; CVA: 20 vs. 0 vs. 0\%, P = 0.013; heart block: 30 vs. 4 vs. 12\%, P = 0.050). Patients with no LGE had no 30-day MACCE events and no deaths up to 2 years of follow-up.CONCLUSIONS: The myocardial LGE holds promise as a means of predicting risk prior to AVR for AS.",

keywords = "Risk assessment, CARDIOMYOPATHY, Myocardial fibrosis, PREDICTOR, Magnetic resonance, MORTALITY, MIDWALL FIBROSIS, Aortic valve stenosis, CARDIAC MAGNETIC-RESONANCE, STENOSIS, LEFT-VENTRICULAR HYPERTROPHY",

author = "Cesare Quarto and Dweck, \{Marc R.\} and Timothy Murigu and Sanjiv Joshi and Giovanni Melina and Emiliano Angeloni and Prasad, \{Sanjay K.\} and Pepper, \{John R.\}",

year = "2012",

month = jul,

doi = "10.1093/icvts/ivs098",

language = "English",

volume = "15",

pages = "45--50",

journal = "Interactive cardiovascular and thoracic surgery",

issn = "1569-9293",

publisher = "Oxford University Press",

number = "1",

note = "25th Annual Meeting of the European-Association-for-Cardio-Thoracic-Surgery (EACTS) ; Conference date: 01-10-2011 Through 05-10-2011",

}

TY - JOUR

T1 - Late gadolinium enhancement as a potential marker of increased perioperative risk in aortic valve replacement

AU - Quarto, Cesare

AU - Dweck, Marc R.

AU - Murigu, Timothy

AU - Joshi, Sanjiv

AU - Melina, Giovanni

AU - Angeloni, Emiliano

AU - Prasad, Sanjay K.

AU - Pepper, John R.

PY - 2012/7

Y1 - 2012/7

N2 - OBJECTIVES: Risk assessment of patients with aortic stenosis (AS) undergoing aortic valve replacement (AVR) is challenging. We set out to determine the impact of myocardial late gadolinium enhancement (LGE), as detected by cardiovascular magnetic resonance (CMR), on postoperative outcomes following AVR.METHODS: A prospective observational study was conducted on patients undergoing CMR using the LGE technique within 1 year of subsequent AVR. Patients were categorized into absent, mid-wall or infarct patterns of LGE by independent observers blinded to all clinical data, and data were collected with regard to 30-day mortality, major adverse cardiac and cerebrovascular events (MACCE) and postoperative complications.RESULTS: A total of 63 patients were studied. Twenty-five patients had no LGE; 20 had mid-wall LGE and 18 had an infarct pattern. The incidence of MACCE, cerebrovascular accident (CVA) and heart block were significantly higher in the mid-wall group compared with the other two groups (MACCE: 25 vs. 0 vs. 5%, P = 0.014; CVA: 20 vs. 0 vs. 0%, P = 0.013; heart block: 30 vs. 4 vs. 12%, P = 0.050). Patients with no LGE had no 30-day MACCE events and no deaths up to 2 years of follow-up.CONCLUSIONS: The myocardial LGE holds promise as a means of predicting risk prior to AVR for AS.

AB - OBJECTIVES: Risk assessment of patients with aortic stenosis (AS) undergoing aortic valve replacement (AVR) is challenging. We set out to determine the impact of myocardial late gadolinium enhancement (LGE), as detected by cardiovascular magnetic resonance (CMR), on postoperative outcomes following AVR.METHODS: A prospective observational study was conducted on patients undergoing CMR using the LGE technique within 1 year of subsequent AVR. Patients were categorized into absent, mid-wall or infarct patterns of LGE by independent observers blinded to all clinical data, and data were collected with regard to 30-day mortality, major adverse cardiac and cerebrovascular events (MACCE) and postoperative complications.RESULTS: A total of 63 patients were studied. Twenty-five patients had no LGE; 20 had mid-wall LGE and 18 had an infarct pattern. The incidence of MACCE, cerebrovascular accident (CVA) and heart block were significantly higher in the mid-wall group compared with the other two groups (MACCE: 25 vs. 0 vs. 5%, P = 0.014; CVA: 20 vs. 0 vs. 0%, P = 0.013; heart block: 30 vs. 4 vs. 12%, P = 0.050). Patients with no LGE had no 30-day MACCE events and no deaths up to 2 years of follow-up.CONCLUSIONS: The myocardial LGE holds promise as a means of predicting risk prior to AVR for AS.

KW - Risk assessment

KW - CARDIOMYOPATHY

KW - Myocardial fibrosis

KW - PREDICTOR

KW - Magnetic resonance

KW - MORTALITY

KW - MIDWALL FIBROSIS

KW - Aortic valve stenosis

KW - CARDIAC MAGNETIC-RESONANCE

KW - STENOSIS

KW - LEFT-VENTRICULAR HYPERTROPHY

U2 - 10.1093/icvts/ivs098

DO - 10.1093/icvts/ivs098

M3 - Article

SN - 1569-9293

VL - 15

SP - 45

EP - 50

JO - Interactive cardiovascular and thoracic surgery

JF - Interactive cardiovascular and thoracic surgery

IS - 1

T2 - 25th Annual Meeting of the European-Association-for-Cardio-Thoracic-Surgery (EACTS)

Y2 - 1 October 2011 through 5 October 2011

ER -

Late gadolinium enhancement as a potential marker of increased perioperative risk in aortic valve replacement

Abstract

Keywords / Materials (for Non-textual outputs)

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