Hosamadin Assadi1, Rachel Jones1, Andrew J Swift1, Abdallah Al-Mohammad2, Pankaj Garg3. 1. Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK. 2. Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK; Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK. 3. Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK; Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK. Electronic address: pankaj.garg@nhs.net.
Abstract
BACKGROUND: Cardiac magnetic resonance imaging (MRI) is emerging as an important imaging tool in the assessment of heart failure with preserved ejection fraction (HFpEF). This systematic review and meta-analysis aim to synthesise and consolidate the current literature on cardiac MRI for prognostication of HFpEF. METHODS DESIGN: Systematic review and meta-analysis. DATA SOURCES: Scopus (PubMed and Embase) for studies published between 2008 and 2019. Eligibility criteria for study selection were studies that evaluated the prognostic role of cardiac MRI in HFpEF. Random effects meta-analyses of the reported hazard ratios (HR) for clinical outcomes was performed. RESULTS: Initial screening identified 97 studies. From these, only nine (9%) studies met all the criteria. The main cardiac MRI methods that demonstrated association to prognosis in HFpEF included late gadolinium enhancement (LGE) assessment of scar (n = 3), tissue characterisation with T1-mapping (n = 4), myocardial ischaemia (n = 1) and right ventricular dysfunction (RVSD) (n = 1). The pooled HR for all 9 studies was 1.52 (95% CI 1.05-1.99, P < 0.01). Sub-evaluation by cardiac MRI methods revealed varying HRs: LGE (net n = 402, HR = 1.6, 95% CI 0.42-2.78, P = 0.008); T1-mapping (n = 1623, HR = 1.25, 95% CI 0.891-1.60, P < 0.001); myocardial ischaemia or RVSD (n = 325, HR = 3.19, 95% CI 0.30-6.08, P = 0.03). CONCLUSION: This meta-analysis demonstrates that multiparametric cardiac MRI has value in prognostication of patients with HFpEF. HFpEF patients with a detectable scar on LGE, fibrosis on T1-mapping, myocardial ischaemia or RVSD appear to have a worse prognosis. PROSPERO REGISTRATION NUMBER: CRD42020187228.
BACKGROUND: Cardiac magnetic resonance imaging (MRI) is emerging as an important imaging tool in the assessment of heart failure with preserved ejection fraction (HFpEF). This systematic review and meta-analysis aim to synthesise and consolidate the current literature on cardiac MRI for prognostication of HFpEF. METHODS DESIGN: Systematic review and meta-analysis. DATA SOURCES: Scopus (PubMed and Embase) for studies published between 2008 and 2019. Eligibility criteria for study selection were studies that evaluated the prognostic role of cardiac MRI in HFpEF. Random effects meta-analyses of the reported hazard ratios (HR) for clinical outcomes was performed. RESULTS: Initial screening identified 97 studies. From these, only nine (9%) studies met all the criteria. The main cardiac MRI methods that demonstrated association to prognosis in HFpEF included late gadolinium enhancement (LGE) assessment of scar (n = 3), tissue characterisation with T1-mapping (n = 4), myocardial ischaemia (n = 1) and right ventricular dysfunction (RVSD) (n = 1). The pooled HR for all 9 studies was 1.52 (95% CI 1.05-1.99, P < 0.01). Sub-evaluation by cardiac MRI methods revealed varying HRs: LGE (net n = 402, HR = 1.6, 95% CI 0.42-2.78, P = 0.008); T1-mapping (n = 1623, HR = 1.25, 95% CI 0.891-1.60, P < 0.001); myocardial ischaemia or RVSD (n = 325, HR = 3.19, 95% CI 0.30-6.08, P = 0.03). CONCLUSION: This meta-analysis demonstrates that multiparametric cardiac MRI has value in prognostication of patients with HFpEF. HFpEF patients with a detectable scar on LGE, fibrosis on T1-mapping, myocardial ischaemia or RVSD appear to have a worse prognosis. PROSPERO REGISTRATION NUMBER: CRD42020187228.
Authors: Pankaj Garg; Rebecca Gosling; Peter Swoboda; Rachel Jones; Alexander Rothman; Jim M Wild; David G Kiely; Robin Condliffe; Samer Alabed; Andrew J Swift Journal: Eur Heart J Date: 2022-07-07 Impact factor: 35.855
Authors: Pankaj Garg; Robert A Lewis; Christopher S Johns; Andrew J Swift; David Capener; Smitha Rajaram; A A Roger Thompson; Robin Condliffe; Charlie A Elliot; Athanasios Charalampopoulos; Abdul G Hameed; Alexander Rothman; Jim M Wild; David G Kiely Journal: Int J Cardiovasc Imaging Date: 2021-05-12 Impact factor: 2.357