Cargando…

CMR detects decreased myocardial deformation in asymptomatic patients at risk for heart failure

AIMS: The main management strategy of heart failure with preserved ejection fraction (HFpEF) is prevention since HFpEF is associated with many cardiovascular (CV) risk factors, especially since HFpEF is linked to a high risk for both mortality and recurrent heart failure (HF) hospitalizations. There...

Descripción completa

Detalles Bibliográficos
Autores principales: Hashemi, Djawid, Doeblin, Patrick, Blum, Moritz, Weiss, Karl Jakob, Schneider, Matthias, Korosoglou, Grigorios, Beyer, Rebecca Elisabeth, Pieske, Burkert, Edelmann, Frank, Kelle, Sebastian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9849678/
https://www.ncbi.nlm.nih.gov/pubmed/36684590
http://dx.doi.org/10.3389/fcvm.2022.1091768
_version_ 1784872002923790336
author Hashemi, Djawid
Doeblin, Patrick
Blum, Moritz
Weiss, Karl Jakob
Schneider, Matthias
Korosoglou, Grigorios
Beyer, Rebecca Elisabeth
Pieske, Burkert
Edelmann, Frank
Kelle, Sebastian
author_facet Hashemi, Djawid
Doeblin, Patrick
Blum, Moritz
Weiss, Karl Jakob
Schneider, Matthias
Korosoglou, Grigorios
Beyer, Rebecca Elisabeth
Pieske, Burkert
Edelmann, Frank
Kelle, Sebastian
author_sort Hashemi, Djawid
collection PubMed
description AIMS: The main management strategy of heart failure with preserved ejection fraction (HFpEF) is prevention since HFpEF is associated with many cardiovascular (CV) risk factors, especially since HFpEF is linked to a high risk for both mortality and recurrent heart failure (HF) hospitalizations. Therefore, there is a need for new tools to identify patients with a high risk profile early. Regional strain assessment by CMR seems to be superior in describing deformation impairment in HF. The MyoHealth score is a promising tool to identify cardiac changes early. METHODS AND RESULTS: Heart failure patients irrespective of LVEF and asymptomatic controls were recruited, and CMR based measures were obtained. For this analysis the asymptomatic control group (n = 19) was divided into asymptomatic subjects without CV co-morbidities or evidence of cardiac abnormalities and (n = 12) and asymptomatic subjects with CV co-morbidities or evidence of cardiac abnormalities (n = 7) as well as patients with HFpEF (n = 19). We performed CMR scans at rest and during a stress test using isometric handgrip exercise (HG). Assessing the MyoHealth score at rest revealed preserved regional strain in 85 ± 9% of LV segments in controls, 73 ± 11% in at Risk subjects and 73 ± 8% in HFpEF patients. During stress the MyoHealth score was 84 ± 7% in controls, 83 ± 7 in at risk subjects and 74 ± 11 in HFpEF patients. CONCLUSION: In summary, we show for the first time that asymptomatic subjects with increased CV risk present with HFpEF like impaired myocardial deformation at rest, while they show results like controls under HG stress. The potential of preventive treatment in this group of patients merits further investigation in future. CLINICAL TRIAL REGISTRATION: [https://drks.de/search/de/trial/DRKS00015615], identifier [DRKS00015615].
format Online
Article
Text
id pubmed-9849678
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-98496782023-01-20 CMR detects decreased myocardial deformation in asymptomatic patients at risk for heart failure Hashemi, Djawid Doeblin, Patrick Blum, Moritz Weiss, Karl Jakob Schneider, Matthias Korosoglou, Grigorios Beyer, Rebecca Elisabeth Pieske, Burkert Edelmann, Frank Kelle, Sebastian Front Cardiovasc Med Cardiovascular Medicine AIMS: The main management strategy of heart failure with preserved ejection fraction (HFpEF) is prevention since HFpEF is associated with many cardiovascular (CV) risk factors, especially since HFpEF is linked to a high risk for both mortality and recurrent heart failure (HF) hospitalizations. Therefore, there is a need for new tools to identify patients with a high risk profile early. Regional strain assessment by CMR seems to be superior in describing deformation impairment in HF. The MyoHealth score is a promising tool to identify cardiac changes early. METHODS AND RESULTS: Heart failure patients irrespective of LVEF and asymptomatic controls were recruited, and CMR based measures were obtained. For this analysis the asymptomatic control group (n = 19) was divided into asymptomatic subjects without CV co-morbidities or evidence of cardiac abnormalities and (n = 12) and asymptomatic subjects with CV co-morbidities or evidence of cardiac abnormalities (n = 7) as well as patients with HFpEF (n = 19). We performed CMR scans at rest and during a stress test using isometric handgrip exercise (HG). Assessing the MyoHealth score at rest revealed preserved regional strain in 85 ± 9% of LV segments in controls, 73 ± 11% in at Risk subjects and 73 ± 8% in HFpEF patients. During stress the MyoHealth score was 84 ± 7% in controls, 83 ± 7 in at risk subjects and 74 ± 11 in HFpEF patients. CONCLUSION: In summary, we show for the first time that asymptomatic subjects with increased CV risk present with HFpEF like impaired myocardial deformation at rest, while they show results like controls under HG stress. The potential of preventive treatment in this group of patients merits further investigation in future. CLINICAL TRIAL REGISTRATION: [https://drks.de/search/de/trial/DRKS00015615], identifier [DRKS00015615]. Frontiers Media S.A. 2023-01-05 /pmc/articles/PMC9849678/ /pubmed/36684590 http://dx.doi.org/10.3389/fcvm.2022.1091768 Text en Copyright © 2023 Hashemi, Doeblin, Blum, Weiss, Schneider, Korosoglou, Beyer, Pieske, Edelmann and Kelle. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Hashemi, Djawid
Doeblin, Patrick
Blum, Moritz
Weiss, Karl Jakob
Schneider, Matthias
Korosoglou, Grigorios
Beyer, Rebecca Elisabeth
Pieske, Burkert
Edelmann, Frank
Kelle, Sebastian
CMR detects decreased myocardial deformation in asymptomatic patients at risk for heart failure
title CMR detects decreased myocardial deformation in asymptomatic patients at risk for heart failure
title_full CMR detects decreased myocardial deformation in asymptomatic patients at risk for heart failure
title_fullStr CMR detects decreased myocardial deformation in asymptomatic patients at risk for heart failure
title_full_unstemmed CMR detects decreased myocardial deformation in asymptomatic patients at risk for heart failure
title_short CMR detects decreased myocardial deformation in asymptomatic patients at risk for heart failure
title_sort cmr detects decreased myocardial deformation in asymptomatic patients at risk for heart failure
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9849678/
https://www.ncbi.nlm.nih.gov/pubmed/36684590
http://dx.doi.org/10.3389/fcvm.2022.1091768
work_keys_str_mv AT hashemidjawid cmrdetectsdecreasedmyocardialdeformationinasymptomaticpatientsatriskforheartfailure
AT doeblinpatrick cmrdetectsdecreasedmyocardialdeformationinasymptomaticpatientsatriskforheartfailure
AT blummoritz cmrdetectsdecreasedmyocardialdeformationinasymptomaticpatientsatriskforheartfailure
AT weisskarljakob cmrdetectsdecreasedmyocardialdeformationinasymptomaticpatientsatriskforheartfailure
AT schneidermatthias cmrdetectsdecreasedmyocardialdeformationinasymptomaticpatientsatriskforheartfailure
AT korosoglougrigorios cmrdetectsdecreasedmyocardialdeformationinasymptomaticpatientsatriskforheartfailure
AT beyerrebeccaelisabeth cmrdetectsdecreasedmyocardialdeformationinasymptomaticpatientsatriskforheartfailure
AT pieskeburkert cmrdetectsdecreasedmyocardialdeformationinasymptomaticpatientsatriskforheartfailure
AT edelmannfrank cmrdetectsdecreasedmyocardialdeformationinasymptomaticpatientsatriskforheartfailure
AT kellesebastian cmrdetectsdecreasedmyocardialdeformationinasymptomaticpatientsatriskforheartfailure