Calcified Aortic Valve Stenosis (AVS). Markers of Fibrosis Using Cardiac Magnetic Resonance
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Aortic Valve Stenosis
- Sponsor
- Assistance Publique - Hôpitaux de Paris
- Enrollment
- 70
- Locations
- 1
- Primary Endpoint
- prevalence of myocardial fibrosis in MRI in patients with AVS
- Status
- Completed
- Last Updated
- 10 years ago
Overview
Brief Summary
Aortic valve stenosis (AVS) is the most frequent valvular disease. The severity of the obstruction of the left ventricle (LV) is essentially analyzed today by echocardiography Doppler, which assesses two key markers that are aortic valve pressure gradient and the aortic valve area. however these marker are a poor reflect of the clinical severity of AVS. The aim of the study is to validate new markers assessing cardiac fibrosis that might best or complementary markers.
Detailed Description
To validate new markers assessing cardiac fibrosis three groups of subjects were studied in controls subjects and patients with AVS in order to : 1. Analyze myocardial fibrosis markers in MRI, the degree of hypertrophy, remodeling and wall shear stress in a control population and in three groups of subjects to RA progressively increasing risk: asymptomatic subjects without symptomatic subjects LV dysfunction, symptomatic patients with LV dysfunction. The factors favoring the appearance of fibrosis observed in MRI will be analyzed on all subjects. 2. To validate these fibrosis markers estimated by MRI by histological analysis of biopsies performed in patients undergoing aortic valve replacement. 3. Monitoring compliance with the distribution of markers of fibrosis and wall stress estimated on Initial MRI are factors of aggravation or not improved function and / or remodeling remote myocardial. Public hospitals in Paris
Investigators
Eligibility Criteria
Inclusion Criteria
- •Echocardiography considered as normal and / or age-related
- •Patients who have received prior clinical examination
- •Patient receiving a social security scheme or entitled, or CMU
- •After having giving written informed consent.
- •Patients symptomatic with indication of surgery (group surgery) or not
Exclusion Criteria
- •With one of the following cardiac abnormalities: atrial fibrillation, more than moderate either aortic or mitral valve regurgitation
- •Heart valve surgery history (aortic, mitral, tricuspid and pulmonary).
- •Indication for cardiac surgery other than on the aortic valve.
- •Usual counter-indications of MRI: Pace-maker, defibrillator, metallic objects including gadolinium allergy.
- •Patients with severe renal insufficiency with a clearance \<30 ml / min estimated by the Cockcroft \& Gault formula.
- •Patient who cannot be followed over the duration of a year.
- •CONTROLS (healthy volunteers)
- •Inclusion criteria:
- •Normal EKG
- •Echocardiography considered normal and / or age-related
Outcomes
Primary Outcomes
prevalence of myocardial fibrosis in MRI in patients with AVS
Time Frame: At one year
Indices of myocardial fibrosis will been analysed as combined criteria to analyse myocardial fibrosis
Secondary Outcomes
- Correlation with Doppler Echocardiography Assessment, and wall stress estimate by using both cardiac MR and carotid artery pressure (applanation tonometry)(At inclusion and at one year)
- comparison of these markers with myocardial histology(At inclusion and at one year)