Left Ventricular Function and Myocardial Triglyceride Content on 3T Cardiac MR Predict Major Cardiovascular Adverse Events and Readmission in Patients Hospitalized with Acute Heart Failure

Abstract

Background: This prospective study was designed to investigate whether myocardial triglyceride (TG) content from proton magnetic resonance spectroscopy (MRS) and left ventricular (LV) function parameters from cardiovascular magnetic resonance imaging (CMR) can serve as imaging biomarkers in predicting future major cardiovascular adverse events (MACE) and readmission in patients who had been hospitalized for acute heart failure (HF). Methods: Patients who were discharged after hospitalization for acute HF were prospectively enrolled. On a 3.0 T MR scanner, myocardial TG contents were measured using MRS, and LV parameters (function and mass) were evaluated using cine. The occurrence of MACE and the HF-related readmission served as the endpoints. Independent predictors were identified using univariate and multivariable Cox proportional hazard regression analyses. Results: A total of 133 patients (mean age, 52.4 years) were enrolled. The mean duration of follow-up in surviving patients was 775 days. Baseline LV functional parameters—including ejection fraction, LV end-diastolic volume, LV end-diastolic volume index (LVEDVI), and LV end-systolic volume (p < 0.0001 for all), and myocardial mass (p = 0.010)—were significantly associated with MACE. Multivariable analysis revealed that LVEDVI was the independent predictor for MACE, while myocardial mass was the independent predictor for 3- and 12-month readmission. Myocardial TG content (lipid resonances δ 1.6 ppm) was significantly associated with readmission in patients with ischemic heart disease. Conclusions: LVEDVI and myocardial mass are potential imaging biomarkers that independently predict MACE and readmission, respectively, in patients discharged after hospitalization for acute HF. Myocardial TG predicts readmission in patients with a history of ischemic heart disease.

Pericardial adiposity is independently linked to adverse cardiovascular phenotypes: a CMR study of 42 598 UK Biobank participants

“…There are several possible explanations for this. Myocardial triglyceride content measured on CMR has previously been associated with higher rates of major cardiovascular events and heart failure hospitalization, 32 but no study thus far has addressed the association between triglyceride levels and cardiac structure and function. The effect observed in this study may be directly related to intramyocardial triglyceride deposition, or may reflect the well-known correlation between obesity, metabolic syndrome, and circulating triglyceride levels.…”

Myocardial steatosis across the spectrum of human health and disease

“…Other investigations targeted myocardial lipid composition in heart failure, rather than total content per se, but research in this area is extremely limited (Chang et al, 2020;Liao et al, 2016). Hata et al…”

“…In one investigation, 1 year of high‐intensity exercise training, without dietary intervention, promoted positive cardiac and vascular remodelling in adults at risk for heart failure, but did not affect myocardial steatosis (Hearon et al., 2022 ). Other investigations targeted myocardial lipid composition in heart failure, rather than total content per se, but research in this area is extremely limited (Chang et al., 2020 ; Liao et al., 2016 ). Hata et al 2022 are the only group to investigate the longitudinal effects of myocardial steatosis on LV diastolic function.…”

7.0T cardiac magnetic resonance imaging of right ventricular function in rats with high-altitude deacclimatization

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