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Article: Intraventricular 4D flow cardiovascular magnetic resonance for assessing patients with heart failure with preserved ejection fraction: a pilot study

TitleIntraventricular 4D flow cardiovascular magnetic resonance for assessing patients with heart failure with preserved ejection fraction: a pilot study
Authors
Keywords4D flow
Cardiovascular magnetic resonance
Direct flow
HFpEF
Intraventricular flow
Residual Volume
Issue Date28-Jun-2023
PublisherSpringer
Citation
The International Journal of Cardiovascular Imaging, 2023 How to Cite?
Abstract

Diagnosing heart failure with preserved ejection fraction (HFpEF) remains challenging. Intraventricular four-dimensional flow (4D flow) phase-contrast cardiovascular magnetic resonance (CMR) can assess different components of left ventricular (LV) flow including direct flow, delayed ejection, retained inflow and residual volume. This could be utilised to identify HFpEF. This study investigated if intraventricular 4D flow CMR could differentiate HFpEF patients from non-HFpEF and asymptomatic controls. Suspected HFpEF patients and asymptomatic controls were recruited prospectively. HFpEF patients were confirmed using European Society of Cardiology (ESC) 2021 expert recommendations. Non-HFpEF patients were diagnosed if suspected HFpEF patients did not fulfil ESC 2021 criteria. LV direct flow, delayed ejection, retained inflow and residual volume were obtained from 4D flow CMR images. Receiver operating characteristic (ROC) curves were plotted. 63 subjects (25 HFpEF patients, 22 non-HFpEF patients and 16 asymptomatic controls) were included in this study. 46% were male, mean age 69.8 ± 9.1 years. CMR 4D flow derived LV direct flow and residual volume could differentiate HFpEF vs combined group of non-HFpEF and asymptomatic controls (p < 0.001 for both) as well as HFpEF vs non-HFpEF patients (p = 0.021 and p = 0.005, respectively). Among the 4 parameters, direct flow had the largest area under curve (AUC) of 0.781 when comparing HFpEF vs combined group of non-HFpEF and asymptomatic controls, while residual volume had the largest AUC of 0.740 when comparing HFpEF and non-HFpEF patients. CMR 4D flow derived LV direct flow and residual volume show promise in differentiating HFpEF patients from non-HFpEF patients.


Persistent Identifierhttp://hdl.handle.net/10722/329108
ISSN
2023 Impact Factor: 1.5
2023 SCImago Journal Rankings: 0.694
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorKwan, Chi Ting-
dc.contributor.authorChing, On Hang Samuel-
dc.contributor.authorYap, Pui Min-
dc.contributor.authorFung, Sau Yung-
dc.contributor.authorTang, Hok Shing-
dc.contributor.authorTse, Wan Wai Vivian-
dc.contributor.authorKwan, Cheuk Nam Felix-
dc.contributor.authorChow, Yin Hay Phoebe-
dc.contributor.authorYiu, Nga Ching-
dc.contributor.authorLee, Yung Pok-
dc.contributor.authorLau, Jessica Wing Ka-
dc.contributor.authorFong, Ambrose Ho Tung-
dc.contributor.authorRen, Qing-Wen-
dc.contributor.authorWu, Mei-Zhen-
dc.contributor.authorWan, Eric Yuk Fai-
dc.contributor.authorLee, Ka Chun Kevin-
dc.contributor.authorLeung, Chun Yu-
dc.contributor.authorLi, Andrew-
dc.contributor.authorMontero, David-
dc.contributor.authorVardhanabhuti, Varut-
dc.contributor.authorHai, Jojo Siu Han-
dc.contributor.authorSiu, Chung Wah-
dc.contributor.authorTse, Hung Fat-
dc.contributor.authorZingan, Valentin-
dc.contributor.authorZhao, Xiaoxi-
dc.contributor.authorWang, Haonan-
dc.contributor.authorPennell, Dudley John-
dc.contributor.authorMohiaddin, Raad-
dc.contributor.authorSenior, Roxy-
dc.contributor.authorYiu, Kai Hang-
dc.contributor.authorNg, Ming Yen-
dc.date.accessioned2023-08-05T07:55:21Z-
dc.date.available2023-08-05T07:55:21Z-
dc.date.issued2023-06-28-
dc.identifier.citationThe International Journal of Cardiovascular Imaging, 2023-
dc.identifier.issn1569-5794-
dc.identifier.urihttp://hdl.handle.net/10722/329108-
dc.description.abstract<p>Diagnosing heart failure with preserved ejection fraction (HFpEF) remains challenging. Intraventricular four-dimensional flow (4D flow) phase-contrast cardiovascular magnetic resonance (CMR) can assess different components of left ventricular (LV) flow including direct flow, delayed ejection, retained inflow and residual volume. This could be utilised to identify HFpEF. This study investigated if intraventricular 4D flow CMR could differentiate HFpEF patients from non-HFpEF and asymptomatic controls. Suspected HFpEF patients and asymptomatic controls were recruited prospectively. HFpEF patients were confirmed using European Society of Cardiology (ESC) 2021 expert recommendations. Non-HFpEF patients were diagnosed if suspected HFpEF patients did not fulfil ESC 2021 criteria. LV direct flow, delayed ejection, retained inflow and residual volume were obtained from 4D flow CMR images. Receiver operating characteristic (ROC) curves were plotted. 63 subjects (25 HFpEF patients, 22 non-HFpEF patients and 16 asymptomatic controls) were included in this study. 46% were male, mean age 69.8 ± 9.1 years. CMR 4D flow derived LV direct flow and residual volume could differentiate HFpEF vs combined group of non-HFpEF and asymptomatic controls (p < 0.001 for both) as well as HFpEF vs non-HFpEF patients (p = 0.021 and p = 0.005, respectively). Among the 4 parameters, direct flow had the largest area under curve (AUC) of 0.781 when comparing HFpEF vs combined group of non-HFpEF and asymptomatic controls, while residual volume had the largest AUC of 0.740 when comparing HFpEF and non-HFpEF patients. CMR 4D flow derived LV direct flow and residual volume show promise in differentiating HFpEF patients from non-HFpEF patients.</p>-
dc.languageeng-
dc.publisherSpringer-
dc.relation.ispartofThe International Journal of Cardiovascular Imaging-
dc.subject4D flow-
dc.subjectCardiovascular magnetic resonance-
dc.subjectDirect flow-
dc.subjectHFpEF-
dc.subjectIntraventricular flow-
dc.subjectResidual Volume-
dc.titleIntraventricular 4D flow cardiovascular magnetic resonance for assessing patients with heart failure with preserved ejection fraction: a pilot study-
dc.typeArticle-
dc.identifier.doi10.1007/s10554-023-02909-8-
dc.identifier.scopuseid_2-s2.0-85163447835-
dc.identifier.eissn1573-0743-
dc.identifier.isiWOS:001018125600001-
dc.identifier.issnl1569-5794-

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