Key result
Lower LVEF, reduced T2-SI ratio, and enlarged LA independently track with higher NT-proBNP in HFrEF.
Why the study?
Associations between NT-proBNP and cardiac magnetic resonance functional, structural, and tissue characterization parameters in patients with HFrEF remain unclear.
Cross-Sectional (n=92)
Blinded image analysis
No
In patients with HFrEF, lower LVEF, lower T2-SI ratio, and larger LA diameter on CMR are independently associated with higher NT-proBNP levels, suggesting these imaging markers reflect distinct pathophysiological aspects of heart failure.
Answers are grounded in this paper and cite their sources.
May refine HFrEF phenotyping with CMR; leaves open incremental prognostic value over NT-proBNP alone.
Background/Objectives: N-terminal pro-B-type natriuretic peptide (NT-proBNP) is an established heart failure biomarker, but its associations with cardiac magnetic resonance (CMR) parameters in patients with reduced ejection fraction remain unclear. This study examined the associations between serum NT-proBNP concentrations and CMR-derived functional, structural, and tissue characterization parameters in patients with HFrEF and evaluated which imaging parameters remained associated with NT-proBNP after multivariable adjustment. Methods: This retrospective single-center study included 92 consecutive patients with HFrEF who underwent CMR and NT-proBNP measurement within a 24 h window, with a median absolute interval of 6 h (range, 1–15 h) between the two assessments. CMR analysis included left ventricular ejection fraction (LVEF), left ventricular and left atrial (LA) cavity diameters, myocardial mass, extracellular volume fraction (ECV), the late gadolinium enhancement (LGE) burden, and the T2 signal intensity (T2-SI) ratio. Spearman correlation, univariate linear regression, and multivariable linear regression analyses were performed using log-transformed NT-proBNP values. Results: Log NT-proBNP demonstrated significant correlations with LVEF (rs = −0.359, p < 0.001), T2-SI ratio (rs = −0.332, p = 0.001), ECV (rs = 0.383, p < 0.001), and LA diameter (rs = 0.347, p < 0.001). No statistically significant correlations were observed between log-transformed NT-proBNP and LGE burden, LV cavity diameter, myocardial mass, LV wall thickness, age, or the recorded comorbidities. In multivariable analysis, LVEF, T2-SI ratio, and LA diameter remained associated with NT-proBNP after adjustment for the available covariates. Conclusions: Lower LVEF, a lower T2-SI ratio, and a larger LA diameter were associated with higher NT-proBNP levels in patients with HFrEF. The T2-SI ratio and LA diameter should be considered exploratory imaging markers requiring prospective validation.
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Memiş et al. (2026) conducted a cross-sectional in Heart failure with reduced ejection fraction (HFrEF) (n=92). Cardiac magnetic resonance (CMR) parameters was evaluated on Association of T2-SI ratio with log-transformed NT-proBNP in multivariable analysis (B = -0.209 per 0.1-unit increase, 95% CI -0.346 to -0.071, p=0.003). Lower LVEF, a lower T2-SI ratio, and a larger LA diameter were independently associated with higher NT-proBNP levels in patients with HFrEF.
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