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Prevalence and prognostic value of late gadolinium enhancement on CMR in aortic stenosis: meta-analysis.

Abstract：

OBJECTIVES:The aim of this study was to investigate the prevalence and prognostic value of late gadolinium enhancement (LGE), as assessed by cardiovascular magnetic resonance (CMR) imaging, in patients with aortic stenosis. METHODS AND RESULTS:A systematic search of PubMed and EMBASE was performed, and observational cohort studies that analysed the prevalence of LGE and its relation to clinical outcomes in patients with aortic stenosis were included. Odds ratios were used to measure an effect of the presence of LGE on both all-cause and cardiovascular mortality. Nineteen studies were retrieved, accounting for 2032 patients (mean age 69.8 years, mean follow-up 2.8 years). We found that LGE is highly prevalent in aortic stenosis, affecting half of all patients (49.6%), with a non-infarct pattern being the most frequent type (63.6%). The estimated extent of focal fibrosis, expressed in % of LV mass, was equal to 3.83 (95% CI [2.14, 5.52], p < 0.0001). The meta-analysis showed that the presence of LGE was associated with increased all-cause (pooled OR [95% CI] = 3.26 [1.72, 6.18], p = 0.0003) and cardiovascular mortality (pooled OR [95% CI] = 2.89 [1.90, 4.38], p < 0.0001). CONCLUSIONS:LGE by CMR is highly prevalent in aortic stenosis patients and exhibits a substantial value in all-cause and cardiovascular mortality prediction. These results suggest a potential role of LGE in aortic stenosis patient risk stratification. KEY POINTS:• Up to the half of aortic stenosis patients are affected by myocardial focal fibrosis. • Sixty-four percent of focal fibrosis detected by LGE-CMR is non-infarct type. • The presence of focal fibrosis triples all-cause and cardiovascular mortality.

journal_name

Eur Radiol

journal_title

European radiology

authors

Balciunaite G,Skorniakov V,Rimkus A,Zaremba T,Palionis D,Valeviciene N,Aidietis A,Serpytis P,Rucinskas K,Sogaard P,Glaveckaite S

doi

10.1007/s00330-019-06386-3

subject

Has Abstract

pub_date

2020-01-01 00:00:00

pages

640-651

issue

1

eissn

0938-7994

issn

1432-1084

pii

10.1007/s00330-019-06386-3

journal_volume

30

pub_type

杂志文章,meta分析

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