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OBJECTIVES: The aim of this study was to assess the effect of sex on myocardial fibrosis as assessed by using cardiac magnetic resonance (CMR) imaging in aortic stenosis (AS). BACKGROUND: Previous studies reported sex-related differences in the left ventricular (LV) remodeling response to pressure overload in AS. However, there are very few data regarding the effect of sex on myocardial fibrosis, a key marker of LV decompensation and adverse cardiac events in AS. METHODS: A total of 249 patients (mean age 66 ± 13 years; 30% women) with at least mild AS were recruited from 2 prospective observational cohort studies and underwent comprehensive Doppler echocardiography and CMR examinations. On CMR, T1 mapping was used to quantify extracellular volume (ECV) fraction as a marker of diffuse fibrosis, and late gadolinium enhancement (LGE) was used to assess focal fibrosis. RESULTS: There was no difference in age between women and men (age 66 ± 15 years vs 66 ± 12 years; p = 0.78). However, women presented with a better cardiovascular risk profile than men with less hypertension, dyslipidemia, diabetes, and coronary artery disease (all, p ≤ 0.10). As expected, LV mass index measured by CMR imaging was smaller in women than in men (p 

Original publication




Journal article


Jacc cardiovasc imaging

Publication Date





699 - 711


aortic stenosis, myocardial fibrosis, sex differences, Aged, Aged, 80 and over, Aortic Valve Stenosis, Cross-Sectional Studies, Female, Fibrosis, Health Status Disparities, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Myocardium, Predictive Value of Tests, Prospective Studies, Quebec, Risk Factors, Scotland, Severity of Illness Index, Sex Factors, Ventricular Function, Left, Ventricular Remodeling