CMR-Analysis (including machine learning)

1328683 - Heart Failure with Normal Natriuretic Peptide and preserved Ejection Fraction: A Prospective Clinical and CMR study

Wednesday, January 25, 2023

Location: E-POSTER

Presenting Author(s)

JH

Jian He

PhD
Fuwai hospital, China (People's Republic)

Primary Author(s)

JH

Jian He

PhD
Fuwai hospital, China (People's Republic)

Co-Author(s)

WY

Wenjing Yang

PhD
Fuwai hospital, China (People's Republic)
YW

Yining Wang, MD

Dr
Fuwai Hospital, State Key Laboratory Of Cardiovascular Disease，National Center For Cardiovascular Diseases, Beijing, China (People's Republic)
ML

Minjie Lu, MD, PhD

PhD
Fuwai Hospital, State Key Laboratory Of Cardiovascular Disease，National Center For Cardiovascular Diseases, Beijing, China (People's Republic)

Background: Defining predisposed heart failure with preserved ejection fraction (HFpEF) with normal natriuretic peptide (NP) levels based on up-to-date ESC guidelines (reaching four points by HFA-PEFF score) using cardiovascular magnetic resonance (CMR) would be more accessible to understand its pathophysiology, yet scarcely been evaluated. To “phenomap” the clinical presentation and comprehensive CMR features in predisposed HFpEF patients.

Methods:

We consecutively included a total of 464 participants including 213 HFpEF patients, 151 predisposed HFpEF patients, and 100 control subjects who underwent CMR. Clinical features and CMR characteristics were comprehensively analyzed.

Results: Compared with controls, the predisposed HFpEF patients were older, higher body mass index, higher plasma volume, more comorbidities, and worse left ventricular (LV) remodeling and function. There were no differences in sex or NYHA functional class between HFpEF and predisposed HFpEF patients. Compared with HFpEF patients, predisposed HFpEF patients were younger (50±14 vs 59±14 years), had higher plasma volume, higher prevalence of hypertension, and obesity (55.0% vs 27.2%), yet lower prevalence of atrial fibrillation (12.6% vs 39.4%), and better LV global longitudinal strain (GLS), while lower left atrial maximal volume index (LAVi), and maximal extracellular volume fraction (ECVmax, all p< 0.05), much aligned with the propensity-score matching cohort. In a multivariable logistic model, obesity, LAVi, GLS, and ECVmax were independently associated with the identification of predisposed HFpEF patients (AUC=0.866, p< 0.001).

Conclusion:

The predisposed HFpEF phenotype showed similar clinical presentation versus HFpEF patients. Obesity, and CMR derived LAVi, GLS, and ECVmax showed potential to monitor the predisposed HFpEF patients.