Clinical Outcomes and Prognosis
Djawid Hashemi, MD
Physician / Clinician Scientist
Charité – Universitätsmedizin Berlin
Berlin, Berlin, Germany
Djawid Hashemi, MD
Physician / Clinician Scientist
Charité – Universitätsmedizin Berlin
Berlin, Berlin, Germany
Patrick Doeblin, MD
Cardiologist
German Heart Center Charité, Germany
Moritz Blum, MD
Resident
Charité – Universitätsmedizin Berlin, New York, Germany
Karl Jakob Weiss, MD
Physician
German Heart Center of the Charité
Berlin, Berlin, Germany
Matthias Schneider, MD
Physician
Charité – Universitätsmedizin Berlin, Berlin, Germany
Rebecca Elisabeth Beyer, MD
Resident
Charité & German Cardiac centere, Germany
Burkert Pieske, MD
Head of Departement
Charité – Universitätsmedizin Berlin, Berlin, Germany
Hans-Dirk Duengen, MD
Physician
Charité – Universitätsmedizin Berlin, Berlin, Germany
Frank Edelmann, MD
Physician
Charité – Universitätsmedizin Berlin, Berlin, Germany
Sebastian Kelle, MD, FSCMR
Cardiologist
German Heart Center Berlin
Berlin, Berlin, Germany
Heart failure (HF) does not only reduce the life expectancy in patients, but their life is also often limited by HF symptoms leading to a reduced quality of life (QoL) and a diminished exercise capacity. While the prognostic value of findings in cardiac imaging have been explored, the association of findings in routine parameters with symptoms and the wellbeing of patients is poorly studied.
An imaging parameter indicating with power the clinical presentation of the patients would add to the descriptive value and make cardiac imaging more robust towards incomplete information.
Methods:
This prospective study conducted at two centres in Germany between 2017 and 2018 enrolled stable outpatient subjects with HF [n = 56, including HF with reduced ejection fraction (HFrEF), HF with mid-range ejection fraction (HFmrEF), and HF with preserved ejection fraction (HFpEF)] and a control cohort (n = 12). Parameters assessed included measures for external myocardial function, for example, cardiac index and myocardial deformation measurements by cardiovascular magnetic resonance imaging, left ventricular global longitudinal strain (GLS), the global circumferential strain (GCS) and the regional distribution of segment deformation within the LV myocardium, as well as basic phenotypical characteristics including the Minnesota Living with Heart Failure Questionnaire (MLHFQ) and the 6 minute walking test (6MWT).
Results:
If less than 80% of the LV segments are preserved in their deformation capacity the QoL by MLHFQ, the subjective symptom burden (NYHA functional class), the shortness of breath during the 6MWT as well as the walking distance during the 6MWT are affected.
Conclusion:
The share of LV segments with preserved myocardial contraction allows to discriminate between symptomatic and asymptomatic subjects based on the imaging findings, even when the LV ejection fraction is preserved. This finding is promising to make imaging studies more robust towards incomplete clinical information.