| Title: | Risk factors for raised left ventricular filling pressure by cardiovascular magnetic resonance: Prognostic insights |
| Journal: | ESC Heart Failure |
| Published: | 12 Aug 2024 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/39132877/ |
| DOI: | https://doi.org/10.1002/ehf2.15011 |
Publication 12996
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Abstract
BACKGROUND: Cardiovascular magnetic resonance (CMR) imaging shows promise in estimating pulmonary capillary wedge pressure (PCWP) non-invasively. At the population level, the prognostic role of CMR-modelled PCWP remains unknown. Furthermore, the relationship between CMR-modelled PCWP and established risk factors for cardiovascular disease has not been well characterized.</p>
OBJECTIVE: The main aim of this study was to investigate the prognostic value of CMR-modelled PCWP at the population level.</p>
METHODS: Employing data from the imaging substudy of the UK Biobank, a very large prospective population-based cohort study, CMR-modelled PCWP was calculated using a model incorporating left atrial volume, left ventricular mass and sex. Logistic regression explored the relationships between typical cardiovascular risk factors and raised CMR-modelled PCWP (≥15 mmHg). Cox regression was used to examine the impact of typical risk factors and CMR-modelled PCWP on heart failure (HF) and major adverse cardiovascular events (MACE).</p>
RESULTS: Data from 39 163 participants were included in the study. Median age of all participants was 64 years (inter-quartile range: 58 to 70), and 47% were males. Clinical characteristics independently associated with raised CMR-modelled PCWP included hypertension [odds ratio (OR) 1.57, 95% confidence interval (CI) 1.44-1.70, P < 0.001], body mass index (BMI) [OR 1.57, 95% CI 1.52-1.62, per standard deviation (SD) increment, P < 0.001], male sex (OR 1.37, 95% CI 1.26-1.47, P < 0.001), age (OR 1.33, 95% CI 1.27-1.41, per decade increment, P < 0.001) and regular alcohol consumption (OR 1.10, 95% CI 1.02-1.19, P = 0.012). After adjusting for potential confounders, CMR-modelled PCWP was independently associated with incident HF [hazard ratio (HR) 2.91, 95% CI 2.07-4.07, P < 0.001] and MACE (HR 1.48, 95% CI 1.16-1.89, P = 0.002).</p>
CONCLUSIONS: Raised CMR-modelled PCWP is an independent risk factor for incident HF and MACE. CMR-modelled PCWP should be incorporated into routine CMR reports to guide HF diagnosis and further management.</p>
9 Authors
- Ross J. Thomson
- Ciaran Grafton-Clarke
- Gareth Matthews
- Peter P. Swoboda
- Andrew J. Swift
- Alejandro Frangi
- Steffen E. Petersen
- Nay Aung
- Pankaj Garg
1 Application
| Application ID | Title |
|---|---|
| 2964 | Description of cardiovascular phenotype in the UK Biobank population based on cardiovascular magnetic resonance and carotid ultrasound |
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