1. Cardiac MRI for the prognostication of heart failure with preserved ejection fraction: A systematic review and meta-analysis
- Author
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Abdallah Al-Mohammad, Hosamadin Assadi, Rachel Jones, Andrew J. Swift, and Pankaj Garg
- Subjects
iECV, Total Extracellular Volume of the myocardium indexed to body surface area ,RVEF, Right Ventricular Ejection Fraction ,Late gadolinium enhancement ,030218 nuclear medicine & medical imaging ,0302 clinical medicine ,LGE, Late Gadolinium Enhancement ,Fibrosis ,HFpEF, Heart Failure with preserved Ejection Fraction ,NICM, Non-Ischaemic Cardiomyopathy ,ECHO, Echocardiography ,AHA, American Heart Association ,medicine.diagnostic_test ,Hazard ratio ,VT, Ventricular Tachycardia ,Heart ,Original Contribution ,Prognosis ,Magnetic Resonance Imaging ,LVEDV, Left Ventricular End-Diastolic Volume ,Meta-analysis ,Cardiology ,PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses ,medicine.medical_specialty ,MOLLI, Modified Look-Locker Inversion recovery ,TTE, Transthoracic Echocardiography ,Biomedical Engineering ,Biophysics ,Heart failure ,MRI, Magnetic Resonance Imaging ,03 medical and health sciences ,RVSD, Right Ventricular Systolic Dysfunction ,Imaging Tool ,Cardiac magnetic resonance imaging ,Internal medicine ,medicine ,ECV, Extracellular Volume ,Humans ,Radiology, Nuclear Medicine and imaging ,NYHA, New York Heart Association ,Cardiac MRI ,LVEF, Left Ventricular Ejection Fraction ,business.industry ,MI, Myocardial Infarction ,PROSPERO, International Prospective Register of Systematic Reviews ,HF, Heart Failure ,HCM, Hypertrophic Cardiomyopathy ,Stroke Volume ,ROC, Receiver Operating Characteristic curve ,T1 mapping ,medicine.disease ,HFpEF ,MACE, Major Adverse Cardiovascular Events ,Heart failure with preserved ejection fraction ,business ,030217 neurology & neurosurgery - Abstract
Background\ud \ud 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.\ud \ud \ud Methods design\ud \ud 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.\ud \ud \ud Results\ud \ud 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).\ud \ud \ud Conclusion\ud \ud 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.\ud \ud \ud PROSPERO registration number\ud \ud CRD42020187228.
- Published
- 2021