{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:23:23Z","timestamp":1790774603530,"version":"4.1.0"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Imaging"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Aortic stenosis is accompanied by progressive left ventricular hypertrophy and fibrosis. We investigated the natural history of these processes in asymptomatic patients and their potential reversal post-aortic valve replacement (AVR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Asymptomatic and symptomatic patients with aortic stenosis underwent repeat echocardiography and magnetic resonance imaging. Changes in peak aortic-jet velocity, left ventricular mass index, diffuse fibrosis (indexed extracellular volume), and replacement fibrosis (late gadolinium enhancement [LGE]) were quantified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      In 61 asymptomatic patients (43% mild, 34% moderate, and 23% severe aortic stenosis), significant increases in peak aortic-jet velocity, left ventricular mass index, indexed extracellular volume, and LGE mass were observed after 2.1\u00b10.7 years, with the most rapid progression observed in patients with most severe stenosis. Patients with baseline midwall LGE (n=16 [26%]; LGE mass, 2.5 g [0.8\u20134.8 g]) demonstrated particularly rapid increases in scar burden (78% [50%\u2013158%] increase in LGE mass per year). In 38 symptomatic patients (age, 66\u00b18 years; 76% men) who underwent AVR, there was a 19% (11%\u201325%) reduction in left ventricular mass index (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.0001) and an 11% (4%\u201316%) reduction in indexed extracellular volume (\n                      <jats:italic>P<\/jats:italic>\n                      =0.003) 0.9\u00b10.3 years after surgery. By contrast midwall LGE (n=10 [26%]; mass, 3.3 g [2.6\u20138.0 g]) did not change post-AVR (n=10; 3.5 g [2.1\u20138.0 g];\n                      <jats:italic>P<\/jats:italic>\n                      =0.23), with no evidence of regression even out to 2 years.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>In patients with aortic stenosis, cellular hypertrophy and diffuse fibrosis progress in a rapid and balanced manner but are reversible after AVR. Once established, midwall LGE also accumulates rapidly but is irreversible post valve replacement. Given its adverse long-term prognosis, prompt AVR when midwall LGE is first identified may improve clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration:<\/jats:title>\n                    <jats:p>\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      . Unique identifiers: NCT01755936 and NCT01679431.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circimaging.117.007451","type":"journal-article","created":{"date-parts":[[2018,6,18]],"date-time":"2018-06-18T04:55:11Z","timestamp":1529297711000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":200,"title":["Progression of Hypertrophy and Myocardial Fibrosis in Aortic Stenosis"],"prefix":"10.1161","volume":"11","author":[{"given":"Russell J.","family":"Everett","sequence":"first","affiliation":[{"name":"British Heart Foundation Centre for Cardiovascular Science (R.J.E., J.K., M.G., E.J.R.v.B., C.W., S.S., D.E.N., M.R.D.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lionel","family":"Tastet","sequence":"additional","affiliation":[{"name":"University of Edinburgh, United Kingdom. Department of Medicine, Quebec Heart and Lung Institute, Canada (L.T., M.-A.C., R.C., E.L., P.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Annick","family":"Clavel","sequence":"additional","affiliation":[{"name":"University of Edinburgh, United Kingdom. Department of Medicine, Quebec Heart and Lung Institute, Canada (L.T., M.-A.C., R.C., E.L., P.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Calvin W.L.","family":"Chin","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Science, National Heart Center Singapore (C.W.L.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romain","family":"Capoulade","sequence":"additional","affiliation":[{"name":"University of Edinburgh, United Kingdom. Department of Medicine, Quebec Heart and Lung Institute, Canada (L.T., M.-A.C., R.C., E.L., P.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vassilios S.","family":"Vassiliou","sequence":"additional","affiliation":[{"name":"Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, London, United Kingdom (V.S.V., S.K.P.)."},{"name":"Norwich Medical School, Norfolk and Norwich University Hospital, United Kingdom (V.S.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacek","family":"Kwiecinski","sequence":"additional","affiliation":[{"name":"British Heart Foundation Centre for Cardiovascular Science (R.J.E., J.K., M.G., E.J.R.v.B., C.W., S.S., D.E.N., M.R.D.)"},{"name":"First Department of Cardiology, Poznan University of Medical Sciences, Poland (J.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miquel","family":"Gomez","sequence":"additional","affiliation":[{"name":"British Heart Foundation Centre for Cardiovascular Science (R.J.E., J.K., M.G., E.J.R.v.B., C.W., S.S., D.E.N., M.R.D.)"},{"name":"Hospital del Mar Medical Research Institute, Universitat Pompeu Fabra, Barcelona, Spain (M.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edwin J.R.","family":"van Beek","sequence":"additional","affiliation":[{"name":"British Heart Foundation Centre for Cardiovascular Science (R.J.E., J.K., M.G., E.J.R.v.B., C.W., S.S., D.E.N., M.R.D.)"},{"name":"Edinburgh Imaging Queen\u2019s Medical Research Institute Facility (E.J.R.v.B., S.S.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audrey C.","family":"White","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay K.","family":"Prasad","sequence":"additional","affiliation":[{"name":"Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, London, United Kingdom (V.S.V., S.K.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Larose","sequence":"additional","affiliation":[{"name":"University of Edinburgh, United Kingdom. Department of Medicine, Quebec Heart and Lung Institute, Canada (L.T., M.-A.C., R.C., E.L., P.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Tuck","sequence":"additional","affiliation":[{"name":"British Heart Foundation Centre for Cardiovascular Science (R.J.E., J.K., M.G., E.J.R.v.B., C.W., S.S., D.E.N., M.R.D.)"},{"name":"Edinburgh Clinical Trials Unit, Usher Institute of Population Health Sciences and Informatics (C.T.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Semple","sequence":"additional","affiliation":[{"name":"British Heart Foundation Centre for Cardiovascular Science (R.J.E., J.K., M.G., E.J.R.v.B., C.W., S.S., D.E.N., M.R.D.)"},{"name":"Edinburgh Imaging Queen\u2019s Medical Research Institute Facility (E.J.R.v.B., S.S.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David E.","family":"Newby","sequence":"additional","affiliation":[{"name":"British Heart Foundation Centre for Cardiovascular Science (R.J.E., J.K., M.G., E.J.R.v.B., C.W., S.S., D.E.N., M.R.D.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Pibarot","sequence":"additional","affiliation":[{"name":"University of Edinburgh, United Kingdom. Department of Medicine, Quebec Heart and Lung Institute, Canada (L.T., M.-A.C., R.C., E.L., P.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc R.","family":"Dweck","sequence":"additional","affiliation":[{"name":"British Heart Foundation Centre for Cardiovascular Science (R.J.E., J.K., M.G., E.J.R.v.B., C.W., S.S., D.E.N., M.R.D.)"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0195-668X(03)00201-X"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.02.093"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000051865.66123.B7"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.03.064"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.12.074"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.02.612"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2016.10.007"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.01.034"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2014.09.016"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.21119"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1186\/1532-429X-13-75"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12968-014-0085-x"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jet245"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.12.035"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.95.9.2262"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.930636"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.79.4.744"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx353"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.08.064"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1093\/icvts\/ivs098"}],"container-title":["Circulation: Cardiovascular Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCIMAGING.117.007451","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T22:17:23Z","timestamp":1715552243000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCIMAGING.117.007451"}},"subtitle":["A Multicenter Cardiac Magnetic Resonance Study"],"short-title":[],"issued":{"date-parts":[[2018,6]]},"references-count":20,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2018,6]]}},"alternative-id":["10.1161\/CIRCIMAGING.117.007451"],"URL":"https:\/\/doi.org\/10.1161\/circimaging.117.007451","relation":{},"ISSN":["1941-9651","1942-0080"],"issn-type":[{"value":"1941-9651","type":"print"},{"value":"1942-0080","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,6]]},"assertion":[{"value":"2017-12-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-04-23","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-06-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e007451"}}