Noncontrast Cardiac Magnetic Resonance Imaging Predictors of Heart Failure Hospitalization in Heart Failure With Preserved Ejection Fraction

2021 ◽  
Author(s):  
Selcuk Kucukseymen ◽  
Arghavan Arafati ◽  
Talal Al‐Otaibi ◽  
Hossam El‐Rewaidy ◽  
Ahmed S. Fahmy ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Heart Failure ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Ejection Fraction ◽  
Cardiac Magnetic Resonance Imaging ◽  
Preserved Ejection Fraction ◽  
Resonance Imaging ◽  
Heart Failure Hospitalization

Abstract 11776: Relative Merits of Ejection Fraction and Strain by 2D Echo, 3D Echo and Cardiac Magnetic Resonance Imaging for Image-Based Recognition of Heart Failure

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Samir K Saha ◽  
Rena S Toole ◽  
Anatoli Kiotsekoglou ◽  
Jie J Cao ◽  
Nathaniel Reichek ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Heart Failure ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Ejection Fraction ◽  
Cardiac Magnetic Resonance Imaging ◽  
Systolic Dysfunction ◽  
Resonance Imaging ◽  
Backward Elimination ◽  
Sensitivity Specificity

Introduction: Echo and cardiac magnetic resonance imaging (CMR) are often used in evaluation of patients with heart failure (HF) whether associated with systolic dysfunction or preserved ejection fraction (EF). We evaluated the relative merits of EF (by CMR and 2D echo) versus echo strain (by 2D and 3D speckle tracking echo STE) for imaged-based recognition of patients with HF. Methods: 117 subjects (81 normals and 36 HF) were evaluated. There were no significant differences in age or gender between normals (59+/-14 yrs, 39 M) and HF (54+/-14 yrs, 29 M). 2D biplane echo and CMR provided EF while 2D and 3DSTE yielded global longitudinal (GLS %) and circumferential (GCS%) strains. Since 3DSTE was optimized for strain rather than EF, 3DEF was not evaluated. HF diagnosis was based on dyspnea, plasma N-terminal pro-B type brain natriuretic peptide and EF. Results: As expected, mean EF and strains differed between normals and HF (table). Using a backward elimination regression model, only 2DEF, CMREF, 2DGCS% and 3DGLS% were retained for further analysis. ROC-guided criterion values (for HF recognition) for 2DEF, CMREF, 2DGCS% and 3DGLS% were >52%, >50%, >-22% and >-16%, respectively. Using these values, the sensitivity, specificity, and odd-ratios for HF recognition with each parameter were computed (table). Conclusions: CMREF provided the highest sensitivity and specificity for HF recognition. The most sensitive echo measure was 3DGLS% while the most specific echo measure was 2DEF. However, in a mixed population of normals and HF, whether associated with systolic dysfunction or preserved EF, 2DGCS% and 3DGLS% had the highest odds ratios.

Abstract MP31: Left Ventricular Hypertrophy by Electrocardiogram versus Cardiac Magnetic Resonance Imaging as a Predictor for Heart Failure: The MESA Study

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Abdullahi O Oseni ◽  
Waqas T Qureshi ◽  
Mohammed F Almahmoud ◽  
Alain Bertoni ◽  
David A Bluemke ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Heart Failure ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Left Ventricular Hypertrophy ◽  
Cardiac Magnetic Resonance Imaging ◽  
Ventricular Hypertrophy ◽  
Predictive Ability ◽  
Left Ventricular ◽  
Resonance Imaging

Background: Left ventricular hypertrophy (LVH) is an established risk factor for heart failure (HF). However, it is unknown whether LVH detected by electrocardiogram (ECG-LVH) is equivalent to LVH ascertained by cardiac magnetic resonance imaging (MRI-LVH) in terms of prediction of incident HF using risk prediction models like the Framingham Heart Failure Risk Score (FHFRS). Methods: This analysis included 4745 (mean age 61+10 years, 53.5% women, 61.7% non-whites) from the Multi-Ethnic Study of Atherosclerosis who were free of cardiovascular disease at the time of enrollment. ECG-LVH was defined using Cornell’s criteria while MRI-LVH was derived from left ventricular (LV) mass measured by cardiac MRI. Cox proportional hazard regression was used to examine the association between ECG-LVH and MRI-LVH with incident HF. Harrell’s concordance C-index was used to estimate the predictive ability of the FHFRS when either ECG-LVH or MRI-LVH were included as one of its components. The added predictive ability of ECG-LVH and MRI-LVH were investigated using integrated discrimination improvement (IDI) index and relative IDI. Results: ECG-LVH was present in 291(6.1%) while MRI-LVH was present in 499 (10.5%) of the participants. Over a median follow up of 10.4 years, 140 participants developed HF. Both ECG-LVH [HR (95% CI): 2.25(1.38-3.69)] and MRI-LVH [HR (95% CI): 3.80(1.56-5.63)] were associated with an increased risk of HF in multivariable adjusted models (Table 1). The ability of FHFRS to predict HF was improved with MRI-LVH (C-index 0.871, 95% CI: 0.842-0.899) when compared with ECG-LVH (C-index 0.860, 95% CI: 0.833-0.888) (p < 0.0001). To assess the potential clinical utility of using LVH-MRI instead of ECG-LVH, we calculated several measures of reclassification (Table 1), which were consistent with the statistically significantly improved C-statistic with MRI-LVH. Conclusion: Both ECG-LVH and MRI-LVH are predictive of HF when used in the FHFRS. Substituting MRI-LVH for ECG-LVH improves the predictive ability of the FHFRS.

Sign in / Sign up

Export Citation Format

Share Document