Association between left ventricular strain and fibrosis in severe aortic regurgitation with preserved ejection fraction: a magnetic resonance and histology study

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main source(s): Institutional Grant Na Homolce Hospital Background The presence and extent myocardial fibrosis are associated with poor outcomes in patients severe aortic regurgitation. In the present study, we tested a correlation between left ventricular (LV) strain derived by using feature-tracking cardiac magnetic resonance (MRI) diffuse percentage (DMF%) at quantitative histology. Methods A study population included 23 (age 51 ± 12 years, 78% males) who underwent perioperative biopsy during valve surgery for regurgitation had satisfactory pre-surgery MRI. Myocardial specimens obtained deep needle technique from basal interventricular septum were stained picrosirius red, digitalized, analyzed Image J software pathologist blinded to imaging findings. DMF% was calculated as ratio total collagen content area. MRI-derived global longitudinal-(GLS), circumferential- (GCS), radial (GRS) strain, well their heart rate systolic blood pressure, assessed certified imager histological analysis. Results Compared normal values, all showed increased (19 9%) decreased GLS (15 2%) despite preserved LV ejection fraction (64 7%). Out parameters, only GLS/heart ratio, GCS/heart extracellular volume significant (Table 1, Figure 1). contrast, GCS tended correlate DMF%. remaining parameters including GRS did not show association. Patients focal midwall scar late gadolinium enhancement (n=8, 35%), which mainly localized septum, similar than without (14.5±2.3 vs 15.3±2.3, p = 0.768). Conclusions Feature-tracking-derived ratios over most promising indices non-invasive assessment fraction. 1 Legend Correlation GLS/HR 1A) 1B) %. histology Picrosirius red (collagen fibers red).