High resolution imaging of FFPE valvular heart disease biopsies

Valvular heart disease (VHD) is the 3rd commonest cardiovascular disease after hypertension and coronary disease, predominantly affecting the aortic valve (AoV). Degeneration of the AoV causes pressure-overload (aortic stenosis; AS) or volume-overload (aortic regurgitation; AR) of the left ventricle. The resultant adverse remodelling of the myocardium eventually results in adverse outcomes including heart failure, arrhythmia and premature death. While we and others have studied the adverse remodelling by standard light microscopy and cardiac magnetic resonance, there is a need to understand how this relates to changes in microstructure. In this proposal, we aim to perform multi-scale phase contrast tomography on formalin-fixed paraffin-embedded (FFPE) biopsies from patients with severe AS or AR who have undergone aortic valve replacement, and further assess whether myocyte and microvascular organisation relate to disease category and macrostructural remodelling by cardiac MRI.