Heart failure & cardiomyopathies
Non-invasive estimation of right atrial pressure using magnetic resonance imaging: a development and validation study
Authors' conclusion
An MRI model incorporating abdominal venous and hepatic tissue biomarkers provides a clinically useful, well-calibrated approach for estimating invasive RAP.
Study context
- Population
- Adults who underwent clinically indicated magnetic resonance imaging (MRI) and right heart catheterization within 48 h between 2016 and 2025adults with MRI and right heart catheterization within 48 h · development cohort 125 · held-out test-set cohort 56
- Participants
- 181 adults
- Index test or model
- MRI-based model vs invasive right atrial pressure (RAP) by right heart catheterization
- Target condition
- invasive RAP (elevated RAP >5, >10, >15 mmHg)
Methodological detailsdevelopment cohort and independent held-out test-set cohort stratified by RAP category, generalized additive models and systematic transformation screening, three internal validation approaches
- Development cohort and independent held-out test-set cohort stratified by RAP category
- Generalized additive models and systematic transformation screening
- Three internal validation approaches
Performance
As reported in the abstract
R2
0.621
Root-mean-square error
2.78 mmHg
Mean absolute error
2.07 mmHg
Concordance coefficient
0.777
Further findings
Model performance, development cohort
- Adjusted R2
- 0.698
- Residual standard deviation
- 2.58 mmHg
- Consistent across three internal validation approaches
Calibration in the testing set
- Intercept
- + 0.18
- Slope
- 0.92
- Integrated calibration index
- 0.65 mmHg
Discrimination for elevated RAP
- AUC (>5 mmHg)
- 0.749
- AUC (>10 mmHg)
- 0.949
- AUC (>15 mmHg)
- 0.965
Original publication
Non-invasive estimation of right atrial pressure using magnetic resonance imaging: a development and validation study. Eur Heart J Cardiovasc Imaging. Published 30 August 2026. doi:10.
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