Heart failure & cardiomyopathies
Exercise cardiac magnetic resonance biventricular volumetric reserve in heart failure with preserved ejection fraction
Authors' conclusion
Ex-CMR-based assessment of LV/RV volumetric reserve reveals progressive biventricular dysfunction across HFpEF stages and supports biventricular volumetric reserve-based phenotyping for characterizing HFpEF pathophysiology.
Study context
- Population
- Heart failure with preserved ejection fraction (HFpEF) patients across early to advanced stages undergoing supine ergometer exercise CMR
- Participants
- 140 patients
- Exposure
- HFpEF stages vs healthy controls and non-cardiac dyspnoea
- Healthyn = 40reference
- Non-cardiac dyspnoea (NCD)n = 27
- HFpEFn = 73
- Outcome
- Biventricular volumetric reserve on exercise CMR
Main finding
As reported in the abstract
- All HFpEF subgroups: impaired LVEDV reserve and reduced LVEI
- P < .0001
- LVESV reserve impaired only in stage C
- P < .0001
- Exercise-induced RV dysfunction a hallmark of HFpEF with pulmonary hypertension
- P < .0001
- Biventricular efficiency index (EI) declined progressively with advancing HFpEF stage
- P < .0001
Observational data: associations, not effects.
Further findings
Biventricular EI by NYHA class
- Significantly lower in NYHA > II
- P = 0.0006
Composite reserve phenotyping
- Distinct reserve phenotypes
- 6
Original publication
Exercise cardiac magnetic resonance biventricular volumetric reserve in heart failure with preserved ejection fraction. Eur J Heart Fail. Published 16 April 2026. doi:10.
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