Thomson, R.J., Grafton‐Clarke, C., Matthews, G. et al. (6 more authors) (2024) Risk factors for raised left ventricular filling pressure by cardiovascular magnetic resonance: Prognostic insights. ESC Heart Failure, 11 (6). pp. 4148-4159. ISSN 2055-5822
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.
Objective
The main aim of this study was to investigate the prognostic value of CMR-modelled PCWP at the population level.
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).
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).
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.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2024 The Author(s). ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
Keywords: | cardiovascular magnetic resonance; MRI; left ventricular filling pressure; heart failure epidemiology |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM) > Biomedical Imaging Science Dept (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 16 Sep 2024 10:15 |
Last Modified: | 17 Feb 2025 16:02 |
Status: | Published |
Publisher: | Wiley |
Identification Number: | 10.1002/ehf2.15011 |
Related URLs: | |
Sustainable Development Goals: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:217230 |