How MRI could revolutionize the diagnosis of heart failure

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Using MRIs to detect heart failure could revolutionize the way the disease is diagnosed, thanks to new research from the University of East Anglia and the University of Sheffield.

Until now, the best way to diagnose heart failure has been an invasive evaluation, but it carries risks for patients. The non-invasive echocardiogram, based on ultrasound, is usually used instead, but it is wrong in 50% of cases.

A new study published today shows how magnetic resonance imaging (MRI) is superior to echocardiography for diagnosing heart failure, while also being a powerful tool for predicting patient outcomes, including death.

Lead researcher Dr Pankaj Garg, from UEA’s Norwich Medical School, said: “Heart failure is a terrible condition resulting from increased pressures inside the heart. The best method to diagnose heart failure is the invasive assessment, which is not preferred because it carries risks.

“An echocardiogram, which is an ultrasound of the heart, is usually used to predict the pressure in the heart. However, it is not very accurate.

“We wanted to know if MRI scans could offer a better alternative.”

The research team studied 835 patients who received an invasive assessment and a cardiac MRI on the same day from the ASPIRE Registry, a database of patients assessed at Sheffield’s Pulmonary Vascular Disease Unit.

Dr Garg said: “We investigated whether cardiac MRI could predict invasively measured left ventricular filling pressure.

“Once we identified the key parameters – left atrial volume and left ventricular mass – we created an equation to noninvasively derive the pressure in the heart.

“This simple equation can be applied in any center in the world that performs cardiac MRI.

“We also tested the equation in a separate group of patients and demonstrated its reliability.

“We have shown that cardiac MRI is superior to echocardiography in predicting the pressure inside the heart. Almost 71% of patients who had incorrectly measured pressures by echocardiography had correct pressures by cardiac MRI.

“These results will reduce the need for an invasive assessment. It is not only cost effective, but it also reduces risk for patients, as a cardiac MRI is a completely non-invasive test.

“We have also shown that cardiac MRI results are powerful tools for predicting whether a patient will live or die.

“This research was not possible without the technical expertise of Norwich and Sheffield and the rich hemodynamic data from the ASPIRE registry,” added Dr Garg.

The study was funded by research grants from the Wellcome Trust and the National Institute for Health and Care Research (NIHR), the research partner of the NHS, public health and social services.

Lead author Dr Andy Swift, University of Sheffield and consultant radiologist, said: “This simple diagnostic equation is clinically very useful and will help doctors predict pressure in the heart and diagnose heart disease. ‘heart failure”.

“Testing the use of the equation in other hospitals is the next step to assess patient benefits and the reduced need for invasive testing”

“Cardiac magnetic resonance identifies elevated left ventricular filling pressure: prognostic implications” is published in the European journal of the heart May 5, 2022.


POCUS measure of JVP predicts elevated CVP in heart failure


More information:
Cardiac magnetic resonance identifies elevated left ventricular filling pressure: prognostic implications, European journal of the heart (2022). DOI: 10.1093/eurheartj/ehac207

Provided by the University of East Anglia


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