97 MULTIMODAL EVALUATION OF MYOCARDIAL FIBROSIS IN PATIENTS WITH AORTIC STENOSIS


 
 
 Patients with aortic stenosis often develop hypertrophy and fibrosis, regardless of symptoms. Cardiac magnetic resonance (CMR) represents the gold standard for the evaluation of fibrosis despite numerous limitations: cost, availability, atrial fibrillation, claustrophobia, kidney failure or inability to apnea.
 
 
 
 The aim is to validate the role of echocardiographic parameters, such as Global Longitudinal Strain (GLS), as early marker of fibrosis. Clinical and laboratory data, particularly BNP, were also analyzed.
 
 
 
 In our study we recruited 33 patients with severe aortic stenosis, comparing echocardiographic values of GLS with those of Late Gadolinium Enhancement (LGE) and T1 mapping of CMR.
 
 
 
 70% of patients with an alteration of GLS had LGE+. Univariate logistic regression shows that the factors associated with the presence of LGE on CMR are hypertension (p = 0.043), GLS (p = 0.032) and elevated Pro-BNP values (p = 0.021); for GLS, odds ratio (OR) is 5 so the chance of finding fibrosis on CMR increases 5 times in presence of an altered GLS. The multivariate analysis confirms the association with impaired GLS values (p = 0.033 =) and hypertension (p = 0.025), but not with elevated Pro-BNP values.
 
 
 
 In patients with severe aortic stenosis, association between GLS and LGE can help identify earlier those with structural changes caused by the disease, who could benefit from early intervention. It remains to be established, through a longer follow-up, how the presence of these alterations can influence the outcome of patients suffering from aortic stenosis.
