Aortic stenosis (AS) causes left ventricular remodeling (hypertrophy, remodeling, fibrosis) and other cardiac changes (left atrial dilatation, pulmonary artery, and right ventricular changes). These, and whether they are reversible (reverse remodeling), are major determinants of timing and outcome from transcatheter or surgical aortic valve replacement. Cardiac changes in response to AS afterload can either be adaptive and reversible, or maladaptive and irreversible, where they may convey residual risk after intervention. Structural and hemodynamic assessment of AS therefore needs to evaluate more than the valve and, in particular, the myocardial remodeling response. Imaging plays a key role in this. This Continuing Medical Education activity will review in case vignettes how multimodality imaging evaluates AS myocardial hypertrophy and its components (cellular hypertrophy, fibrosis, microvascular changes, and additional features such as cardiac amyloid), both before and after intervention.

Editors

Editor-in-Chief
Y.S. Chandrashekhar, MD, DM, FACC

CME Editor
Ragavendra R. Baliga, MD

Authors
Thomas A. Treibel, PhD
Sveeta Badiani, MBBS
Guy Lloyd, MD
James C. Moon, MD

CME/MOC/ECME Information

Target Audience

JACC Journal CME/MOC is intended for physicians who treat patients with cardiovascular disease.

Important Dates

Date of Release: August 5, 2019
Term of Approval/Date of CME/MOC/ECME Expiration: August 5, 2020