Myocardial LGE positivity on cardiac MRI was associated with a significantly faster annualized decline in aortic valve area compared to LGE-negative patients (0.165 vs. 0.062 cm²/year; p=0.0029).
Cohort (n=61)
Is the presence of myocardial fibrosis on LGE MRI associated with accelerated progression of aortic stenosis in patients with severe disease?
Myocardial fibrosis detected by LGE on cardiac MRI is associated with a significantly faster hemodynamic progression of severe aortic stenosis, suggesting its potential as a biomarker for rapid disease progression.
Absolute Event Rate: 0.165% vs 0.062%
p-value: p=0.0029
Abstract Background The progression rate of aortic stenosis (AS) varies among individuals, and myocardial fibrosis—detectable as late gadolinium enhancement (LGE) on cardiac MRI—may reflect a more advanced disease phenotype. Prior studies have suggested that rapid AS progression is associated with worse clinical outcomes and increased mortality, but the mechanisms driving this acceleration remain incompletely understood. This study aimed to evaluate the association between LGE positivity and the hemodynamic progression of AS. Methods We retrospectively analyzed 61 patients (mean age: 81.9 years; 43 females) with severe AS who underwent contrast-enhanced cardiac MRI prior to transcatheter aortic valve implantation (TAVI). Patients were stratified by the presence or absence of myocardial LGE. The progression rate of AS was defined as the annualized change in aortic valve area (AVA, cm²/year) based on echocardiographic measurements taken over a mean follow-up duration of 28.5 months. Differences between groups were assessed using the Mann-Whitney U test. Results Among 61 patients, 14 (23%) were LGE-positive. The LGE-positive group showed a significantly faster AVA progression rate than the LGE-negative group (mean 0.165 vs. 0.062 cm²/year; p = 0.0029). Boxplot analysis confirmed a distinct separation between the groups. Conclusion LGE positivity on cardiac MRI is associated with a significantly accelerated decline in AVA among patients with aortic stenosis. Myocardial fibrosis may serve as an imaging biomarker for identifying individuals at risk of rapid disease progression.Accelerated Progression of AS and LGE
Hirata et al. (2026) conducted a cohort in Severe aortic stenosis (n=61). Myocardial late gadolinium enhancement (LGE) positivity vs. LGE-negative was evaluated on Progression rate of AS (annualized change in aortic valve area, cm²/year) (p=0.0029). Myocardial LGE positivity on cardiac MRI was associated with a significantly faster annualized decline in aortic valve area compared to LGE-negative patients (0.165 vs. 0.062 cm²/year; p=0.0029).