Advanced cardiac magnetic resonance (CMR) techniques identify both focal and diffuse myocardial fibrosis in chronic aortic regurgitation (AR) and predict post-AVR remodeling outcomes.
AVR leads to significant left ventricular reverse remodeling characterized by reductions in LV end-diastolic volume (LVEDV), LV mass, and indexed extracellular volume, with cellular regression outpacing matrix regression.
Focal myocardial scars quantified by late gadolinium enhancement (LGE) remain stable post-AVR and are independently associated with incomplete reverse remodeling.
Despite structural improvements, objective functional capacity measured by maximal oxygen consumption may not substantially improve at early follow-up after AVR.
