Besides important risk factors, including hemodynamic response to exercise, AS severity by jet velocity, rate of AS progression, pulmonary hypertension, and elevated brain natriuretic peptides, increasing attention has been given to speckle-tracking echocardiography–derived global longitudinal strain (GLS) measurements and the detection of myocardial fibrosis with CMR. The gene discussed is NPPB; the disease is pulmonary arterial hypertension.