The role of cardiac magnetic resonance imaging in the assessment of heart failure with preserved ejection fraction



Lau, Clement, Elshibly, Mohamed MM, Kanagala, Prathap ORCID: 0000-0001-6739-5607, Khoo, Jeffrey P, Arnold, Jayanth Ranjit and Hothi, Sandeep Singh
(2022) The role of cardiac magnetic resonance imaging in the assessment of heart failure with preserved ejection fraction. FRONTIERS IN CARDIOVASCULAR MEDICINE, 9. 922398-.

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Abstract

Heart failure (HF) is a major cause of morbidity and mortality worldwide. Current classifications of HF categorize patients with a left ventricular ejection fraction of 50% or greater as HF with preserved ejection fraction or HFpEF. Echocardiography is the first line imaging modality in assessing diastolic function given its practicality, low cost and the utilization of Doppler imaging. However, the last decade has seen cardiac magnetic resonance (CMR) emerge as a valuable test for the sometimes challenging diagnosis of HFpEF. The unique ability of CMR for myocardial tissue characterization coupled with high resolution imaging provides additional information to echocardiography that may help in phenotyping HFpEF and provide prognostication for patients with HF. The precision and accuracy of CMR underlies its use in clinical trials for the assessment of novel and repurposed drugs in HFpEF. Importantly, CMR has powerful diagnostic utility in differentiating acquired and inherited heart muscle diseases presenting as HFpEF such as Fabry disease and amyloidosis with specific treatment options to reverse or halt disease progression. This state of the art review will outline established CMR techniques such as transmitral velocities and strain imaging of the left ventricle and left atrium in assessing diastolic function and their clinical application to HFpEF. Furthermore, it will include a discussion on novel methods and future developments such as stress CMR and MR spectroscopy to assess myocardial energetics, which show promise in unraveling the mechanisms behind HFpEF that may provide targets for much needed therapeutic interventions.

Item Type: Article
Uncontrolled Keywords: HFpEF, CMR in HFpEF, diastolic function, diastolic dysfunction, diastolic heart failure
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Clinical Directorate
Depositing User: Symplectic Admin
Date Deposited: 10 Oct 2022 07:53
Last Modified: 18 Jan 2023 20:37
DOI: 10.3389/fcvm.2022.922398
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3165296