The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

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Myocardial fibrosis in severe aortic stenosis: how and when should we measure it?

EuroIntervention 2020;15:1390-1392. DOI: 10.4244/EIJV15I16A252

1. Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands; 2. Department of Cardiology, National University Heart Centre, National University Health System, Singapore


The evidence demonstrating the association between myocardial fibrosis and outcomes after aortic valve replacement in patients with severe aortic stenosis is growing1,2,3,4. The response of the left ventricle to the pressure overload imposed by the stenotic aortic valve is characterised by myocyte hypertrophy with increased muscle fibre diameter and the parallel addition of new myofibrils to maintain left ventricular (LV) systolic function5. Subsequent myocyte apoptosis and replacement fibrosis lead to heart failure, which has been associated with poor outcomes after aortic valve replacement6. The pressure overload also stimulates the secretion of TGF-β1 and the angiotensin-converting enzyme promotes reactive ...

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