Prevalence and prognostic value of late gadolinium enhancement on CMR in aortic stenosis: meta-analysis

Giedre Balciunaite, Viktor Skorniakov, Arnas Rimkus, Tomas Zaremba, Darius Palionis, Nomeda Valeviciene, Audrius Aidietis, Pranas Serpytis, Kestutis Rucinskas, Peter Sogaard, Sigita Glaveckaite

Research output: Contribution to journalReview articlepeer-review

15 Citations (Scopus)


Objectives: The aim of this study was to investigate the prevalence and prognostic value of late gadolinium enhancement (LGE), as assessed by cardiovascular magnetic resonance (CMR) imaging, in patients with aortic stenosis. Methods and results: A systematic search of PubMed and EMBASE was performed, and observational cohort studies that analysed the prevalence of LGE and its relation to clinical outcomes in patients with aortic stenosis were included. Odds ratios were used to measure an effect of the presence of LGE on both all-cause and cardiovascular mortality. Nineteen studies were retrieved, accounting for 2032 patients (mean age 69.8 years, mean follow-up 2.8 years). We found that LGE is highly prevalent in aortic stenosis, affecting half of all patients (49.6%), with a non-infarct pattern being the most frequent type (63.6%). The estimated extent of focal fibrosis, expressed in % of LV mass, was equal to 3.83 (95% CI [2.14, 5.52], p < 0.0001). The meta-analysis showed that the presence of LGE was associated with increased all-cause (pooled OR [95% CI] = 3.26 [1.72, 6.18], p = 0.0003) and cardiovascular mortality (pooled OR [95% CI] = 2.89 [1.90, 4.38], p < 0.0001). Conclusions: LGE by CMR is highly prevalent in aortic stenosis patients and exhibits a substantial value in all-cause and cardiovascular mortality prediction. These results suggest a potential role of LGE in aortic stenosis patient risk stratification. Key Points: • Up to the half of aortic stenosis patients are affected by myocardial focal fibrosis. • Sixty-four percent of focal fibrosis detected by LGE-CMR is non-infarct type. • The presence of focal fibrosis triples all-cause and cardiovascular mortality.

Original languageEnglish
JournalEuropean Radiology
Issue number1
Pages (from-to)640-651
Number of pages12
Publication statusPublished - Jan 2020

Bibliographical note

Correction: "The authors are funded by the Research Council of Lithuania".

Balciunaite, G., Skorniakov, V., Rimkus, A. et al. Correction to: Prevalence and prognostic value of late gadolinium enhancement on CMR in aortic stenosis: meta-analysis. Eur Radiol (2020) 30:5222.


  • Aged
  • Aorta/diagnostic imaging
  • Aortic Valve Stenosis/diagnostic imaging
  • Cohort Studies
  • Contrast Media/pharmacokinetics
  • Female
  • Gadolinium/pharmacokinetics
  • Humans
  • Image Enhancement/methods
  • Magnetic Resonance Imaging/methods
  • Male
  • Middle Aged
  • Observational Studies as Topic
  • Prevalence
  • Prognosis


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