In addition to age, sex, andAS severity, both high-sensitivity cTnI and ECG strain pattern were retained in the finalmodel as independent predictors of midwall fibrosis, consistent with recentliterature.10,11 Rather than individual determinants, an integratedapproach of using the clinical score performed best at identifying midwall myocardialfibrosis. The gene discussed is TNNI3; the disease is fibrosis.