0469: Feasibility and usefulness of cardiac magnetic resonance as a complement to echocardiography in the evaluation of heart failure with preserved left ventricular ejection fraction in elderly patients

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• 作者：Pierre-Laurent Massoure ; ⁽¹⁾ ; ^{plmassoure@aol.com" class="auth_mail" title="E-mail the corresponding author} ; Charline Gabaudan⁽¹⁾ ; Jean-Marie Gil⁽¹⁾ ; Marie-Caroline Chenilleau⁽¹⁾ ; Laurent Fourcade⁽¹⁾ ; Alexis Jacquier⁽²⁾
• 刊名：Archives of Cardiovascular Diseases Supplements
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：8
• 期：1
• 页码：43-44
• 全文大小：242 K

文摘

To evaluate the feasibility and usefulness of cardiovascular magnetic resonance (CMR) in the evaluation of heart failure with preserved left ventricular ejection fraction (HFpEF) in elderly patients.

Methods

Patients aged 65 and older hospitalized for symptomatic heart failure with a left ventricular ejection fraction (LVEF) >40% underwent both CMR and 2D echocardiographic assessment of cardiac volumes, mass and function.

Results

Among 14 patients (mean age 80.2±8.7 Y [66-91]), a good correlation was found between echocardiography and CMR for LVEF (56.7±8.1% vs 54.3±9.2%, r=0.8). Echocardiography mildly underestimated LV end diastolic volume (EDV) (55.6±25.8 vs 67±24.1mL/m ², r=0.84) and end systolic volume (ESV) (24.9±15.8 vs 31.3±13.9mL/m ² r=0.66). Echocardiography overestimated the LV mass (87.4±23.5 vs 64±22.3g/m ², r=0.5). Left atrial volume (assessed by CMR) was increased (52.8±24.9mL/m ²), 8 patients had atrial fibrillation with larger left atrial volume (71.5±26.9 vs 38.8±10.9mL/m ² for sinus rhythm, p 0.008). Right ventricular (RV) EDV and ESV assessed by CMR were normal. Mean RVEF was 43.7±8.7% and RVEF was <45% in 8 (57%) patients who also had lower LVEF (p=0.005) and higher pulmonary artery systolic pressure (p=0.01). Late gadolinium enhancement (LGE) was found in 8 cases, 4 with mid-wall LGE, 2 with subendocardial or transmural LGE and 2 with sub epicardial LGE.

Conclusion

CMR was feasible, safe and was a useful complement to echo-cardiography in elderly patients hospitalized for HFpEF. In this population, LVEF assessed by CMR and echocardiography were comparable. Echocardiography underestimated LV volumes and overestimated LV mass. Risk factors for adverse outcome such as RV dysfunction and the presence of LGE were found in more than half of the cases.