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Cardiac magnetic resonance left ventricular filling pressure is linked to symptoms, signs and prognosis in heart failure

AIMS: Left ventricular filling pressure (LVFP) can be estimated from cardiovascular magnetic resonance (CMR). We aimed to investigate whether CMR‐derived LVFP is associated with signs, symptoms, and prognosis in patients with recently diagnosed heart failure (HF). METHODS AND RESULTS: This study rec...

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Detalles Bibliográficos
Autores principales: Grafton‐Clarke, Ciaran, Garg, Pankaj, Swift, Andrew J., Alabed, Samer, Thomson, Ross, Aung, Nay, Chambers, Bradley, Klassen, Joel, Levelt, Eylem, Farley, Jonathan, Greenwood, John P., Plein, Sven, Swoboda, Peter P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10567675/
https://www.ncbi.nlm.nih.gov/pubmed/37596895
http://dx.doi.org/10.1002/ehf2.14499
Descripción
Sumario:AIMS: Left ventricular filling pressure (LVFP) can be estimated from cardiovascular magnetic resonance (CMR). We aimed to investigate whether CMR‐derived LVFP is associated with signs, symptoms, and prognosis in patients with recently diagnosed heart failure (HF). METHODS AND RESULTS: This study recruited 454 patients diagnosed with HF who underwent same‐day CMR and clinical assessment between February 2018 and January 2020. CMR‐derived LVFP was calculated, as previously, from long‐ and short‐axis cines. CMR‐derived LVFP association with symptoms and signs of HF was investigated. Patients were followed for median 2.9 years (interquartile range 1.5–3.6 years) for major adverse cardiovascular events (MACE), defined as the composite of cardiovascular death, HF hospitalization, non‐fatal stroke, and non‐fatal myocardial infarction. The mean age was 62 ± 13 years, 36% were female (n = 163), and 30% (n = 135) had raised LVFP. Forty‐seven per cent of patients had an ejection fraction < 40% during CMR assessment. Patients with raised LVFP were more likely to have pleural effusions [hazard ratio (HR) 3.2, P = 0.003], orthopnoea (HR 2.0, P = 0.008), lower limb oedema (HR 1.7, P = 0.04), and breathlessness (HR 1.7, P = 0.01). Raised CMR‐derived LVFP was associated with a four‐fold risk of HF hospitalization (HR 4.0, P < 0.0001) and a three‐fold risk of MACE (HR 3.1, P < 0.0001). In the multivariable model, raised CMR‐derived LVFP was independently associated with HF hospitalization (adjusted HR 3.8, P = 0.0001) and MACE (adjusted HR 3.0, P = 0.0001). CONCLUSIONS: Raised CMR‐derived LVFP is strongly associated with symptoms and signs of HF. In addition, raised CMR‐derived LVFP is independently associated with subsequent HF hospitalization and MACE.