Myocardial Fibrosis and Early Intervention in Asymptomatic Patients With Severe Aortic Stenosis

In asymptomatic patients with severe aortic stenosis, is myocardial fibrosis burden associated with adverse events and potential benefits of early valve intervention?In this post hoc analysis of a randomized clinical trial, higher midwall fibrosis burden was associated with increasing incidence of the primary composite end point of all-cause death or unplanned aortic stenosis–related hospitalization. However, the potential beneficial effects of early valve intervention demonstrated no significant heterogeneity by the degree of midwall fibrosis.In this study, in asymptomatic patients with severe aortic stenosis, higher fibrosis burden was associated with adverse outcomes; benefits of early intervention were similar between patients with high and low fibrosis burden.

Corresponding Author: Marc R. Dweck, PhD, University of Edinburgh, 49 Little France Crescent, Edinburgh EH16 4SB, United Kingdom (marc.dweck@ed.ac.uk).

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