Heart failure & cardiomyopathies
Cardiac magnetic resonance (CMR)-derived left ventricular intraventricular pressure gradients identify different patterns associated with prognosis in dilated cardiomyopathy
Authors' conclusion
Pressure reversal during systolic-diastolic transition was observed in one-third of DCM patients, and reversal of blood flow direction predicted worse outcome. In the absence of pressure reversal, lower systolic ejection force, E-wave decelerative force (end of passive LV filling), and overall LV-IVPG are powerful predictors of outcome, independent of clinical and imaging parameters.
Study context
- Population
- Dilated cardiomyopathy (DCM) patients from the Maastricht Cardiomyopathy registry, LV-IVPGs measured on standard CMR cine images66 (15%) with MACE
- Participants
- 447 patients
- Exposure
- LV-IVPG patterns and outcome
- Pressure reversaln = 168
- No pressure reversaln = 279reference
- Outcome
- MACE:
- HF hospitalisations
- Life-threatening arrhythmias
- Sudden/cardiac death
Methodological detailsregistry-based
- Registry-based
Main finding
As reported in the abstract
MACE predictors by LV-IVPG pattern
Hazard ratio (95% CI)P value
Reversal of blood flowin 14%; corrected for univariable predictors
2.57(1.01–6.51)
P = 0.047Overall LV-IVPG (no pressure reversal)independent of known predictors
0.91(0.83–0.99)
P = 0.033Systolic ejection force (no pressure reversal)independent of known predictors
0.91(0.86–0.96)
P < 0.001E-wave decelerative force (no pressure reversal)independent of known predictors
0.83(0.73–0.94)
P = 0.003- Temporary LV-IVPG reversal during systolic-diastolic transition
- 168 patients (38%)
Observational data: associations, not effects.
Original publication
CMR-derived left ventricular intraventricular pressure gradients identify different patterns associated with prognosis in dilated cardiomyopathy. Eur Heart J Cardiovasc Imaging. Published 3 May 2023. doi:10.
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