Cardiac MRI for the prognostication of heart failure with preserved ejection fraction: A systematic review and meta-analysis

Assadi, Hosamadin, Jones, Rachel, Swift, Andrew J., Al-Mohammad, Abdallah and Garg, Pankaj (2021) Cardiac MRI for the prognostication of heart failure with preserved ejection fraction: A systematic review and meta-analysis. Magnetic Resonance Imaging, 76. pp. 116-122. ISSN 0730-725X

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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.

Item Type: Article
Additional Information: Funding Information: This work was supported by the Wellcome Trust (AJ: 205188/Z/16/Z). PG is supported by Academy of Sciences Starter Grant (PG: SGL018\1100) and by Wellcome Trust (PG: 220703/Z/20/Z).
Uncontrolled Keywords: cardiac mri,hfpef,heart failure,late gadolinium enhancement,prognosis,t1 mapping,biophysics,biomedical engineering,radiology nuclear medicine and imaging ,/dk/atira/pure/subjectarea/asjc/1300/1304
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
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Depositing User: LivePure Connector
Date Deposited: 27 Oct 2021 02:24
Last Modified: 03 Nov 2021 08:27
URI: https://ueaeprints.uea.ac.uk/id/eprint/81895
DOI: 10.1016/j.mri.2020.11.011

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