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Cardiac MRI reveals distinct mechanisms in heart failure with preserved ejection fraction

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Cardiac MRI reveals distinct mechanisms in heart failure with preserved ejection fraction

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In heart failure with preserved ejection fraction (HFpEF), the heart's pumping function is largely maintained, yet the heart is unable to fill adequately with blood. A multicenter study by the German Center for Cardiovascular Research (DZHK) now shows that advanced MRI techniques can detect changes in myocardial tissue associated with different mechanisms of impaired cardiac filling. The findings from the DECIPHER HFpEF study have been published in JACC: Cardiovascular Imaging.

HFpEF is a complex form of heart failure. Elevated left ventricular filling pressure plays an important role in its diagnosis. However, this primarily indicates that cardiac filling is impaired and does not directly reveal the mechanisms responsible.

Diastolic dysfunction can arise, for example, when the heart muscle does not relax sufficiently after contraction. Another cause is increased passive myocardial stiffness. Both mechanisms can lead to elevated filling pressures but may require different therapeutic approaches.

In the prospective DECIPHER HFpEF study, researchers led by professor Eike Nagel and professor Andreas Zeiher from the DZHK Rhine-Main partner site and University Hospital Frankfurt investigated patients with suspected HFpEF at seven centers across Germany. They combined cardiovascular magnetic resonance (CMR) with invasive pressure-volume measurements of the heart.

For the current analysis, data were available from 52 patients with invasively confirmed HFpEF. The researchers also studied 32 age- and sex-matched controls and 18 healthy volunteers.

The researchers used T1 and T2 mapping, specialized CMR techniques that provide quantitative information about the composition of myocardial tissue.


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