Histologically Validated Myocardial Fibrosis in Relation to Left Ventricular Geometry and Its Function in Aortic Stenosis

Aitaliyev S. Rumbinaitė E. Jurenas M. Čeponienė I. Keturakis V. Nekrošius R. Orazymbetov Y. Benetis R. Pangonytė D.
April 2024 Multidisciplinary Digital Publishing Institute (MDPI)

Medicina (Lithuania)
2024 #60 Issue 4

Background and Objectives: The combination of aortic valve stenosis (AS) and ischemic heart disease (IHD) is quite common and is associated with myocardial fibrosis (MF). The purpose of this study was to evaluate the association between the histologically verified left ventricular (LV) MF and its geometry and function in isolated AS and AS within IHD groups. Materials and Methods: In a single-center, prospective trial, 116 patients underwent aortic valve replacement (AVR) with/without concomitant surgery. The study population was divided into groups of isolated AS with/without IHD. Echocardiography was used, and LV measurements and aortic valve parameters were obtained from all patients. Myocardial tissue was procured from all study patients undergoing elective surgery. Results: There were no statistical differences between isolated AS and AS+IHD groups in LV parameters or systolic and diastolic functions during the study periods. The collagen volume fraction was significantly different between the isolated AS and AS+IHD groups and was 7.3 ± 5.6 and 8.3 ± 6.4, respectively. Correlations between MF and left ventricular end-diastolic diameter (LVEDD) (r = 0.59, p = < 0.001), left ventricular mass (LVM) (r = 0.42, p = 0.011), left ventricular ejection fraction (LVEF) (r = −0.67, p < 0.001) and an efficient orifice area (EOA) (r = 0.371, p = 0.028) were detected in isolated AS during the preoperative period; the same was observed for LVEDD (r = 0.45, p = 0.002), LVM (r = 0.36, p = 0.026), LVEF (r = −0.35, p = 0.026) and aortic annulus (r = 0.43, p = 0.018) in the early postoperative period; and LVEDD (r = 0.35, p ≤ 0.05), LVM (r = 0.43, p = 0.007) and EOA (r = 0.496, p = 0.003) in the follow-up period. In the group of AS and IHD, correlations were found only with LV posterior wall thickness (r = 0.322, p = 0.022) in the follow-up period. Conclusions: Histological MF in AS was correlated with LVM and LVEDD in all study periods. No correlations between MF and LV parameters were found in aortic stenosis in the ischemic heart disease group across all study periods.

aortic stenosis , aortic valve replacement , collagen volume fraction , ischemic heart disease , left ventricular remodeling , myocardial fibrosis

Text of the article Перейти на текст статьи

Department of Cardiac, Thoracic and Vascular Surgery, Hospital of Lithuanian University of Health Sciences Kauno Klinikos, Lithuanian University of Health Sciences, 2 Eivenių Str., Kaunas, LT-50009, Lithuania
Faculty of Medicine and Health Care, Al-Farabi Kazakh National University, 71 al-Farabi Ave., Almaty, 050040, Kazakhstan
Department of Cardiology, Hospital of Lithuanian University of Health Sciences Kauno Klinikos, Lithuanian University of Health Sciences, 2 Eivenių Str., Kaunas, LT-50009, Lithuania
Lithuanian University of Health Sciences, A. Mickevicius str. 9, Kaunas, LT-44307, Lithuania
Kaunas Region Society of Cardiology, Sukilėlių pr. 17, Kaunas, LT-50157, Lithuania
Institute of Cardiology, Lithuanian University of Health Sciences, 17 Sukilėlių Str., Kaunas, LT-50161, Lithuania
National Scientific Medical Center, 42 Abylaikhan Avenue, Astana, 010009, Kazakhstan

Department of Cardiac
Faculty of Medicine and Health Care
Department of Cardiology
Lithuanian University of Health Sciences
Kaunas Region Society of Cardiology
Institute of Cardiology
National Scientific Medical Center

10 лет помогаем публиковать статьи Международный издатель

Книга Публикация научной статьи Волощук 2026 Book Publication of a scientific article 2026