Heart failure & cardiomyopathiesCohort study
Myocardial Tissue Characterization by Cardiac Magnetic Resonance (CMR) Captures Mechanistic Severity Beyond Filling Pressure in Heart Failure with Preserved Ejection Fraction (HFpEF)
- Prospective cohort study
- multicentre
18 catheterized symptomatic patients with normal resting end-diastolic pressure (EDP) underwent handgrip provocation for a continuum analysis
Authors' conclusion
In invasively characterized HFpEF, CMR tissue mapping captures active relaxation impairment and passive stiffness conditional on filling pressure, robust to clinical covariate adjustment.
Study context
- Population
- Patients with suspected HFpEF undergoing CMR with sequence-corrected tissue mapping and invasive pressure-volume loop analysis
- Participants
- 52 / 32 / 18
- Exposure
- CMR tissue mapping vs invasive pressure-volume loop indices in HFpEF
- HFpEFn = 52
- Matched controlsn = 32reference
- Healthy volunteersn = 18
- Outcome
- Association of CMR tissue mapping (T1c, T2c) with passive stiffness (β) and active relaxation (τ), adjusted for EDP
Main finding
As reported in the abstract
Partial correlations within HFpEF, conditional on EDP
- T1c vs β
- partial ρ 0.47; P = 0.003
- T2c vs τ
- ρ 0.35; P = 0.018
Observational data: associations, not effects.
Further findings
| Outcome | Cliff's δ | P value |
|---|---|---|
| T1c and T2c, HFpEF vs matched controls — HFpEF vs Matched controls · T1c | 0.74 | P < 0.001 |
| T1c and T2c, HFpEF vs matched controls — HFpEF vs Matched controls · T2c | 0.80 | P < 0.001 |
Exploratory clustering on τ and β: 2 phenotypes (mild diastolic dysfunction (DD) n = 24, severe DD n = 28)
- Adjusted Rand index
- 0.78
- Phenotypes separated T1c and T2c
- both P < 0.001
- EDP median split did not separate T1c and T2c
- exploratory, hypothesis-generating
Original publication
Myocardial Tissue Characterization by CMR Captures Mechanistic Severity Beyond Filling Pressure in HFpEF. JACC Cardiovasc Imaging. Published 16 September 2026. doi:10.1016/j.jcmg.2026.07.012
Summarised from the published abstract; every number is checked against it