Invasive stress testing via right heart catheterization during exercise, combined with cardiac magnetic resonance imaging, improves diagnostic sensitivity and accurate staging of patients with HFpEF.
Does the incorporation of invasive stress testing and CMR improve the diagnostic sensitivity and staging of patients with suspected HFpEF?
Incorporating invasive stress testing and CMR into the diagnostic work-up of suspected HFpEF may improve diagnostic sensitivity and accurate staging, particularly for early-stage disease often missed by resting echocardiography and biomarkers.
Heart failure with preserved ejection fraction (HFpEF) is a growing healthcare burden worldwide and its prevalence is increasing. Diagnosing HFpEF is challenging and relies upon the presence of symptoms and/or signs of heart failure, preserved left ventricular systolic function, and evidence of diastolic dysfunction. Current diagnostic algorithms mainly rely on echocardiography (E/e') and biomarkers (NT-proBNP). However, only a minority of patients with HFpEF are identified, and especially HFpEF patients at an early stage of the disease are easily missed. We propose to incorporate invasive stress testing, by means of right heart catheterisation at rest and during exercise, and accurate assessment of right ventricular function, by means of cardiac magnetic resonance imaging. These additions to the current diagnostic work-up will improve diagnostic sensitivity and accurate staging of HFpEF patients.
Veld et al. (Thu,) conducted a review in Heart failure with preserved ejection fraction (HFpEF). Invasive stress testing (right heart catheterization) and CMR vs. Standard non-invasive diagnostic algorithms was evaluated. Invasive stress testing via right heart catheterization during exercise, combined with cardiac magnetic resonance imaging, improves diagnostic sensitivity and accurate staging of patients with HFpEF.
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