Cardiovascular magnetic resonance assessment of coronary flow reserve improves risk stratification in heart failure with preserved ejection fraction View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2021-10-18

AUTHORS

Shingo Kato, Kazuki Fukui, Sho Kodama, Mai Azuma, Naoki Nakayama, Tae Iwasawa, Kazuo Kimura, Kouichi Tamura, Daisuke Utsunomiya

ABSTRACT

BackgroundCoronary microvascular dysfunction (CMD) has been proposed as a novel mechanism for the pathophysiology of heart failure (HF) with preserved ejection fraction (HFpEF). Recent studies have suggested the potential utility of coronary flow reserve (CFR) as a marker of CMD in patients with HFpEF. Phase contrast (PC) cine cardiovascular magnetic resonance (CMR) of the coronary sinus has emerged as a non-invasive method to quantify CFR. We aimed to investigate the prognostic value of CMR-derived CFR in patients with HFpEF.MethodsData from 163 HFpEF patients (73 ± 9 years; 86 [53%] female) were retrospectively analyzed. Coronary sinus blood flow was measured in all patients, and myocardial blood flow was calculated as coronary sinus blood flow divided by left ventricular mass. CFR was calculated as the myocardial blood flow during adenosine triphosphate infusion divided by that at rest. Adverse events were defined as all-cause death and hospitalization due to HF exacerbation. Event-free survival stratified according to CFR < 2.0 was estimated with Kaplan–Meier survival methods and Log-rank test.ResultsDuring a median follow-up of 4.1 years, 26 patients (16%) experienced adverse events. CMR-derived CFR was significantly lower in HFpEF with adverse events compared with those without (1.93 ± 0.38 vs. 2.67 ± 0.52, p < 0.001). On a Kaplan Meier curve, the rates of adverse events were significantly higher in HFpEF patients with CFR < 2.0 compared with HFpEF with CFR ≥ 2.0 (p < 0.001). The area under the curve of CFR for predicting adverse events was significantly higher than that of LGE (0.881 vs. 0.768, p = 0.037) and GLS (0.881 vs. 0.747, p = 0.036).ConclusionsCFR assessed using coronary sinus PC cine CMR may be useful as a non-invasive prognostic marker for HFpEF patients. More... »

PAGES

112

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12968-021-00807-3

DOI

http://dx.doi.org/10.1186/s12968-021-00807-3

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1141960467

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/34657615


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