The ECV (extracellular volume) values, obtained through cardiac magnetic resonance imaging (MRI), are the strong indicators to predict the degree of myocardial fibrosis in patients with aortic stenosis, a local study said.

Cardiology Professor Park Sung-ji and Cardiac Radiology Professor Kim Sung-mok at Samsung Medical Center’s Heart Vascular and Stroke Institute said they made such conclusion by studying the cardiac MRI (ECV, T1) to assess myocardial fibrosis and global longitudinal strain (GLS) values in speckle tracking echocardiography (STE).

Myocardial fibrosis refers to a condition where the heart muscle gradually turns into fibrous tissue and becomes hardened. If a patient with aortic stenosis develops myocardial fibrosis, the progression can be serious.

In such a case, physicians have to take some of the cardiac tissue to evaluate the degree of myocardial fibrosis. However, advanced imaging in echocardiography and cardiac MRI drew attention whether they could replace the traditional biopsy.

Cardiology Professor Park Sung-ji (left) and Cardiac Radiology Professor Kim Sung-mok at Samsung Medical Center’s Heart Vascular and Stroke Institute.

The researchers measured GLS and ECV values of 71 patients with severe aortic stenosis for four years from February 2012 to March 2015. Then, they assessed the degree of myocardial fibrosis during aortic valve replacement operations in three groups.

As a result, the research team found that ECV values were significantly correlated with the degree of myocardial fibrosis than other indicators such as T1 and GLS values.

The researchers said the study would help physicians predict the prognosis and decide the timing of the surgery without histological examination.

“Heart valve disease needs accurate diagnosis through accurate imaging examination. So, a medical professional should determine the diagnosis and treatment,” Professor Park said. “Samsung Medical Center’s heart valve team is making all efforts to get the best treatment effect through examining each different status of individual patients and various imaging tests.”

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