Myocardial contraction fraction derived from cardiovascular magnetic resonance cine images—reference values and performance in patients with heart failure and left ventricular hypertrophy

Arenja, Nisha; Fritz, Thomas; André, Florian; Riffel, Johannes; Siepen, Fabian aus dem; Ochs, Marco; Paffhausen, Judith; Hegenbart, Ute; Schönland, Stefan; Müller-Hennessen, Matthias; Giannitsis, Evangelos; Kristen, Arnt V.; Katus, Hugo A.; Friedrich, Matthias G.; Buss, Sebastian J.

doi:10.1093/ehjci/jew324

Cited by 36 publications

(44 citation statements)

References 24 publications

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“…The left ventricular mass index is a combination of left ventricular mass and baseline body surface area. This index is associated with a variety of heart diseases and prognoses, including coronary heart disease, structural heart disease, and heart failure [28][29][30]. The left ventricular mass index also showed good predictive value for the prognosis of patients with HFrEF in the present study.…”

Section: Discussionsupporting

confidence: 64%

A novel age-biomarker-clinical history prognostic index for heart failure with reduced left ventricular ejection fraction

Yuan

Tian

et al. 2020

Open Medicine

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PurposeA model for predicting the prognosis of patients with heart failure with reduced left ventricular ejection fraction (HFrEF) is currently not available. This study aimed to develop an age-biomarker-clinical history prognostic index (ABC-PI) and validate it for the assessment of individual prognosis.Patients and methodsA total of 5,974 HFrEF patients were enrolled and 1,529 were included in this study after excluding missing values and loss to follow-up. Variables that significantly contributed to prediction of all-cause mortality were assessed by Cox regression and latent trait analysis (LTA) was used to validate discrimination of variables.ResultsAfter Cox regression, the following seven most significant variables were selected: age, N-terminal pro-B-type natriuretic peptide, renal dysfunction, left ventricular mass index, percutaneous coronary intervention, atrial fibrillation, and New York Heart Association (C-index: 0.801 ± 0.013). After verification by LTA, discrimination of these seven variables was proven. A nomogram was used to form the ABC-PI, and then the total score was set to 100 points. A lower score indicated a higher risk. After verification, the 3-year mortality rate was 34.7% in the high-risk group and only 2.6% in the low-risk group.ConclusionOur novel ABC-PI shows a good performance and does not require re-input in the original model. The ABC-PI can be used to effectively and practically predict the prognosis of HFrEF patients.

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Section: Discussionsupporting

confidence: 64%

A novel age-biomarker-clinical history prognostic index for heart failure with reduced left ventricular ejection fraction

Yuan

Tian

et al. 2020

Open Medicine

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“…[46][47][48][49] A recent cardiovascular magnetic resonance study even described a significantly reduced myocardial contraction in LV hypertrophy, independent of aetiology. 50 Interestingly, a primary increase in cardiac output has only been seen in patients with borderline hypertension, and an augmented sympathetic outflow has been suggested to account for the elevation of both cardiac output and vascular resistance in these patients. 51,52 Similar to apparent hypertension, borderline hypertension has been associated with an elevated risk of death.…”

Section: Discussionmentioning

confidence: 99%

Increased long-term mortality in women with high left ventricular ejection fraction: data from the CONFIRM (COronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter) long-term registry

Gebhard

Marędziak

Messerli

et al. 2020

European Heart Journal - Cardiovascular Imaging

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Aims There are significant sex-specific differences in left ventricular ejection fraction (LVEF), with a higher LVEF being observed in women. We sought to assess the clinical relevance of an increased LVEF in women and men. Methods and results A total of 4632 patients from the CONFIRM (COronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter) registry (44.8% women; mean age 58.7 ± 13.2 years in men and 59.5 ± 13.3 years in women, P = 0.05), in whom LVEF was measured by cardiac computed tomography, were categorized according to LVEF (low <55%, normal 55–65%, and high >65%). The prevalence of high LVEF was similar in both sexes (33.5% in women and 32.5% in men, P = 0.46). After 6 years of follow-up, no difference in mortality was observed in patients with high LVEF in the overall cohort (P = 0.41). When data were stratified by sex, women with high LVEF died more often from any cause as compared to women with normal LVEF (8.6% vs. 7.1%, log rank P = 0.032), while an opposite trend was observed in men (5.8% vs. 6.8% in normal LVEF, log rank P = 0.89). Accordingly, a first order interaction term of male sex and high LVEF was significant (hazard ratios 0.63, 95% confidence intervals 0.41–0.98, P = 0.043) in a Cox regression model of all-cause mortality adjusted for age, cardiovascular risk factors, and severity of coronary artery disease (CAD). Conclusion Increased LVEF is highly prevalent in patients referred for evaluation of CAD and is associated with an increased risk of death in women, but not in men. Differentiating between normal and hyperdynamic left ventricles might improve risk stratification in women with CAD. Clinical trial registration https://clinicaltrials.gov/ct2/show/NCT01443637.

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“…MCF calculated via cardiac magnetic resonance imaging (CMR) in nonischemic dilated cardiomyopathy is associated with prognosis [25], as well as in the Framingham Heart Study, where a low MCF predicted the composite outcome of death, myocardial infarction, stroke, or new heart failure [26]. Using cMRI, MCF outperformed EF in discriminating ATTR-CA from controls (AUC = 0.94, sensitivity 81%, specificity 94%) [27]. However, the greater availability and lower cost of echocardiography compared to CMR prompted echocardiography-based investigations of the utility of MCF for risk prediction.…”

Section: Discussionmentioning

confidence: 99%

Myocardial Contraction Fraction by M-Mode Echocardiography Is Superior to Ejection Fraction in Predicting Mortality in Transthyretin Amyloidosis

Rubin

Steidley

Carlsson

et al. 2018

Journal of Cardiac Failure

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Myocardial contraction fraction derived from cardiovascular magnetic resonance cine images—reference values and performance in patients with heart failure and left ventricular hypertrophy

Abstract: In patients with heart failure MCF discriminates CA from other forms of LVH. As it can easily be derived from standard, non-contrast cine images, it may be a very useful marker in the diagnostic workup of patients with LVH.

Cited by 36 publications

References 24 publications

A novel age-biomarker-clinical history prognostic index for heart failure with reduced left ventricular ejection fraction

A novel age-biomarker-clinical history prognostic index for heart failure with reduced left ventricular ejection fraction

Increased long-term mortality in women with high left ventricular ejection fraction: data from the CONFIRM (COronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter) long-term registry

Myocardial Contraction Fraction by M-Mode Echocardiography Is Superior to Ejection Fraction in Predicting Mortality in Transthyretin Amyloidosis

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