The Role of Myocardial Fibrosis in Patients With Aortic Stenosis

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

203 participants

Study Classification

OBSERVATIONAL

Study Start Date

2012-01-31

Study Completion Date

2017-08-31

Brief Summary

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Aortic stenosis is the most common adult valvular heart disease in the western world. Heart failure and sudden cardiac death are complications associated with aortic stenosis. In symptomatic individuals, valve replacement is often the only effective treatment. However, there are no good markers to identify patients who may benefit from early surgery before symptoms developed. The purpose of the study is to test the hypothesis that the presence heart muscle scarring on the cardiac magnetic resonance imaging may predict a worse outcome in patients with aortic stenosis, and thus may be helpful in identifying patients for early valve replacement.

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Detailed Description

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Congestive heart failure and sudden cardiac death are associated complications of aortic stenosis. Currently, the indications for valvular replacement are based on the valvular severity evaluated by echocardiography and the presence of symptoms. There is some evidence to suggest the presence of myocardial fibrosis is associated with a poor outcome in patients with aortic stenosis. The aim of this prospective study is to investigate the prognostic implications of myocardial fibrosis in patients with aortic stenosis. The presence of myocardial fibrosis will be identified by delayed enhancement with the cardiac magnetic resonance imaging at 3T. We will also be evaluating the application of T1 mapping techniques to detect diffuse myocardial fibrosis.

Conditions

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Aortic Stenosis

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Controls

Patients will undergo cardiac magnetic resonance imaging, echocardiography and 72 hour holter monitoring

Cardiac Magnetic Resonance Imaging

Intervention Type OTHER

For the evaluation of left ventricular volumes, function and mass. Also for the assessment of myocardial fibrosis based on the presence of delayed enhancement. Novel application of T1 mapping techniques will be evaluated.

Echocardiography

Intervention Type OTHER

Assessment of aortic stenosis severity. Also evaluate diastolic and systolic function.

72 hour Holter Monitor

Intervention Type OTHER

This will enable us to detect abnormal heart rhythms which may be associated with myocardial fibrosis

Aortic Stenosis patients

All patients who agreed to study will undergo cardiac magnetic resonance imaging, echocardiography and 72 hour holter monitoring

Cardiac Magnetic Resonance Imaging

Intervention Type OTHER

For the evaluation of left ventricular volumes, function and mass. Also for the assessment of myocardial fibrosis based on the presence of delayed enhancement. Novel application of T1 mapping techniques will be evaluated.

Echocardiography

Intervention Type OTHER

Assessment of aortic stenosis severity. Also evaluate diastolic and systolic function.

72 hour Holter Monitor

Intervention Type OTHER

This will enable us to detect abnormal heart rhythms which may be associated with myocardial fibrosis

Interventions

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Cardiac Magnetic Resonance Imaging

For the evaluation of left ventricular volumes, function and mass. Also for the assessment of myocardial fibrosis based on the presence of delayed enhancement. Novel application of T1 mapping techniques will be evaluated.

Intervention Type OTHER

Echocardiography

Assessment of aortic stenosis severity. Also evaluate diastolic and systolic function.

Intervention Type OTHER

72 hour Holter Monitor

This will enable us to detect abnormal heart rhythms which may be associated with myocardial fibrosis

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Patients with aortic stenosis
* Willing to undergo all investigations

Exclusion Criteria

* Coexisting mitral valvular heart disease and aortic regurgitation (more than moderate severity)
* Active medical conditions: ongoing heart failure, infection
* Significant comorbidities: advanced malignancy with limited life expectancy
* Unable to give informed consent
* Contraindication for cardiac magnetic resonance imaging: impaired renal function, pacemaker, claustrophobia

Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes