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September 7, 2026Journal of the American College of CardiologyOpen Access

LGE on CMR is linked to ~180% higher all-cause mortality after SAVR.

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Why the study?

Prior studies showed LGE by CMR detects focal fibrosis in AS, but whether it predicts post-operative survival in severe AS undergoing AVR remained to be evaluated.

Population

154 consecutive surgical AVR and 40 TAVR patients with severe AS

Comparison

Presence vs absence of LGE by CMR

Design

Prospective cohort study

Follow-up

Median 2.9 years

Key result

The presence of late gadolinium enhancement by CMR was an independent predictor of all-cause mortality after surgical aortic valve replacement (HR 2.8; 95% CI 1.3-6.9; p=0.025).

Authors

GBGilles Barone‐RochetteSPSophie PiérardCMChristophe de Meester

Discussion

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Overview

Observational study reveals late gadolinium enhancement on cardiac MRI predicts mortality after aortic valve replacement, indicating risk stratification utility.

Key Points

  • To determine the prognostic significance of myocardial scar detected by late gadolinium enhancement on cardiovascular magnetic resonance in patients with severe aortic stenosis undergoing valve replacement.
  • Evaluated myocardial fibrosis using late gadolinium enhancement (LGE) on cardiovascular magnetic resonance (CMR) imaging prior to valve replacement.
  • Tracked post-procedural clinical outcomes and overall survival in patients following surgical or transcatheter aortic valve replacement.
  • Presence of late gadolinium enhancement was significantly associated with increased risk of post-replacement all-cause mortality and adverse cardiac events.
  • Absence of focal myocardial fibrosis correlated with superior postoperative left ventricular reverse remodeling and improved long-term survival.

Study Design

Type

Cohort (n=194)

PICO

P
Population
194 patients with severe aortic stenosis without prior myocardial infarction undergoing surgical or transcatheter aortic valve replacement, followed for a median of 2.9 years.
E
Exposure / Comparator
Late gadolinium enhancement (LGE) by CMR vs Absence of LGE
O
Primary Outcome
All-cause survival at 5 years (Kaplan-Meier estimates) and all-cause mortality after surgical AVR — HR 2.8 (1.3-6.9), p=0.025

Main Result

Hazard Ratio: 2.8 (95% CI 1.3–6.9)

Absolute Event Rate: 73% vs 88%

p-value: p=0.025

Cite This Study

Barone‐Rochette et al. (2014) conducted a cohort in Severe aortic stenosis (n=194). Late gadolinium enhancement (LGE) by CMR vs. Absence of LGE was evaluated on All-cause survival at 5 years (Kaplan-Meier estimates) and all-cause mortality after surgical AVR (HR 2.8, 95% CI 1.3-6.9, p=0.025). The presence of late gadolinium enhancement by CMR was an independent predictor of all-cause mortality after surgical aortic valve replacement (HR 2.8; 95% CI 1.3-6.9; p=0.025).

synapsesocial.com/papers/6a9ed5dbae051fe680bc566bhttps://doi.org/10.1016/j.jacc.2014.02.612
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Late gadolinium enhancement as a potential marker of increased perioperative risk in aortic valve replacement2012 · 32 citations
  2. 2Prevalence and prognostic significance of left ventricular myocardial late gadolinium enhancement in severe aortic stenosis2017 · 22 citations
  3. 3Late Gadolinium Enhancement in Cardiac MRI in Patients with Severe Aortic Stenosis and Preserved Left Ventricular Systolic Function Is Related to Attenuated Improvement of Left Ventricular Geometry and Filling Pressure after Aortic Valve Replacement2014 · 12 citations
  4. 4Prognostic value of cardiac magnetic resonance in patients with aortic stenosis: A systematic review and meta-analysis2022 · 23 citations
  5. 5Late gadolinium enhancement by cardiovascular magnetic resonance is complementary to left ventricle ejection fraction in predicting prognosis of patients with stable coronary artery disease2012 · 38 citations