A multiparametric CMR score model including left ventricular mass, LGE-fibrosis, and native T1 independently predicted all-cause mortality in patients with HFpEF (HR 4).
Observational (n=86)
No
Does multiparametric CMR predict all-cause mortality in patients with HFpEF?
Multiparametric CMR, specifically quantifying LV mass, LGE fibrosis, and native T1-values, provides independent prognostic value for all-cause mortality in patients with HFpEF.
Effect estimate: HR 4 (95% CI 1.2-13.9)
p-value: p=<0.001
Cardiac magnetic resonance (CMR) is emerging as an important tool in the assessment of heart failure with preserved ejection fraction (HFpEF). This study sought to investigate the prognostic value of multiparametric CMR, including left and right heart volumetric assessment, native T1-mapping and LGE in HFpEF. In this retrospective study, we identified patients with HFpEF who have undergone CMR. CMR protocol included: cines, native T1-mapping and late gadolinium enhancement (LGE). The mean follow-up period was 3.2 ± 2.4 years. We identified 86 patients with HFpEF who had CMR. Of the 86 patients (85% hypertensive; 61% males; 14% cardiac amyloidosis), 27 (31%) patients died during the follow up period. From all the CMR metrics, LV mass (area under curve AUC 0.66, SE 0.07, 95% CI 0.54-0.76, p = 0.02), LGE fibrosis (AUC 0.59, SE 0.15, 95% CI 0.41-0.75, p = 0.03) and native T1-values (AUC 0.76, SE 0.09, 95% CI 0.58-0.88, p 133.24 g (hazard ratio HR 1.58, 95% CI 1.1-2.2, p 34.86% (HR 1.77, 95% CI 1.1-2.8, p = 0.01) and native T1 > 1056.42 ms (HR 2.36, 95% CI 0.9-6.4, p = 0.07). In multivariate cox regression, CMR score model comprising these three variables independently predicted mortality in HFpEF when compared to NTproBNP (HR 4 vs HR 1.65). In non-amyloid HFpEF cases, only native T1 > 1056.42 ms demonstrated higher mortality (AUC 0.833, p < 0.01). In patients with HFpEF, multiparametric CMR aids prognostication. Our results show that left ventricular fibrosis and hypertrophy quantified by CMR are associated with all-cause mortality in patients with HFpEF.
Garg et al. (Tue,) conducted a observational in Heart failure with preserved ejection fraction (HFpEF) (n=86). Multiparametric Cardiac Magnetic Resonance (CMR) was evaluated on All-cause mortality (HR 4, 95% CI 1.2-13.9, p=<0.001). A multiparametric CMR score model including left ventricular mass, LGE-fibrosis, and native T1 independently predicted all-cause mortality in patients with HFpEF (HR 4).