The goal of that study was to assess the correlation of biventricular diffuse myocardial fibrosis in pulmonary hypertension (PH) as assessed by late gadolinium enhancement, extracellular volume (ECV) quantification with serum markers of collagen turnover and conventional prognostic markers from strain echocardiography. Methods: Twelve patients with PH underwent the same day: Transthoracic echocardiography: including measurement of right ventricular (RV) fractional shortening (RVfs), tricuspid annular plane systolic excursion (TAPSE), maximal tricuspid annular velocity, RV global and segmental deformation. Right heart catheterization measuring pulmonary arterial pressures in mmHg and cardiac output in l/min. 1.5T cardiac MRI measuring: right ventricular volumes and ejection fraction, native, and 15min post contrast T1 mapping using modified look-locker inversion-recovery (MOLLI) sequence. Serum quantification of two biomarkers of collagen turnover and hematocrit. Results: Global RV ECV, reflecting the quantity of myocardial fibrosis, was 34%±4.2 for our entire population. A significant correlation was found between RV ECV and: RVfs (r=0.6, p=0.026) S'wave velocity (r=0.7, p=0.009), TAPSE (r=0.6, p=0.040) and RV systolic ejection fraction on the CMR (r=0.6, p=0.04). There was no correlation between the ECV values in the lateral wall of the RV and in the septum (r= 0.4, p=0.206). A significant correlation between septal ECV and 2D septal strain (r=0.7, p=0.013) was found. Lastly, only a tendency was observed between the PIIINP values and RV ECV in a subgroup of 7 patients. 3 Conclusion: ECV quantification in PH appears to correlate with known echocardiographic prognostic markers and more specifically with the markers which assess RV systolic function. These results suggest that RV myocardial fibrosis measured with ECV could become a new prognostic parameter in PH.