Further studies are required to assess whether the association of LVDD parameters (E/E’ ratio, MV DT and LA volume) together with biomarkers (GDF-15 and NT-proBNP) can be used to search high risk asymptomatic patients with severe AS and whether these findings could help in the selection of patients, who would benefit from earlier surgery. The gene discussed is GDF15; the disease is aortic stenosis.