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BACKGROUND: Myocardial fibrosis is a key mechanism of left ventricular decompensation in aortic stenosis and can be quantified using cardiovascular magnetic resonance (CMR) measures such as extracellular volume fraction (ECV%). Outcomes following aortic valve intervention may be linked to the presence and extent of myocardial fibrosis. OBJECTIVES: This study sought to determine associations between ECV% and markers of left ventricular decompensation and post-intervention clinical outcomes. METHODS: Patients with severe aortic stenosis underwent CMR, including ECV% quantification using modified Look-Locker inversion recovery-based T1 mapping and late gadolinium enhancement before aortic valve intervention. A central core laboratory quantified CMR parameters. RESULTS: Four-hundred forty patients (age 70 ± 10 years, 59% male) from 10 international centers underwent CMR a median of 15 days (IQR: 4 to 58 days) before aortic valve intervention. ECV% did not vary by scanner manufacturer, magnetic field strength, or T1 mapping sequence (all p > 0.20). ECV% correlated with markers of left ventricular decompensation including left ventricular mass, left atrial volume, New York Heart Association functional class III/IV, late gadolinium enhancement, and lower left ventricular ejection fraction (p 

Original publication




Journal article


J Am Coll Cardiol

Publication Date





304 - 316


T1 mapping, aortic stenosis, cardiovascular magnetic resonance, diffuse myocardial fibrosis, Aged, Aged, 80 and over, Aortic Valve Stenosis, Extracellular Fluid, Female, Follow-Up Studies, Humans, Longitudinal Studies, Magnetic Resonance Imaging, Cine, Male, Middle Aged, Mortality, Myocardium, Prospective Studies, Stroke Volume, Ventricular Dysfunction, Left