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Background Aortic stenosis (AS) leads to diffuse fibrosis in the myocardium which may impair cardiac function. Existing techniques (late gadolinium enhancement [LGE]) are not good at detecting diffuse, as opposed to focal, fibrosis. Pre-contrast T1-mapping may identify changes in the myocardium without the need for exogenous contrast, and our aim was to investigate its ability to detect diffuse fibrosis in patients with AS. Methods 96 patients with moderate or severe AS were compared to 96 age-and gender-matched controls. Patients were categorized by severity of valve lesion (moderate: peak aortic velocity 3-4 m/s, severe: >4m/s) and symptoms. There were 80 asymptomatic patients under conservative management, and 16 patients with severe symptomatic AS awaiting valve replacement surgery (AVR). Biopsy samples for histological assessment of fibrosis were obtained in 11 of the latter group. All subjects underwent CMR at 1.5T which included pre-contrast T1-mapping using the Shortened Modified Look-Locker Inversion recovery (ShMOLLI) sequence. Average T1 values in the myocardium were analysed on a per-case basis.

Pre-contrast T1 mapping for detection of myocardial fibrosis in asymptomatic and symptomatic aortic stenosis