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Xu L, Pagano J, Chow K, et al. Cardiac remodelling predicts outcome in patients with chronic heart failure. ESC Heart Fail. 2021;8(6):5352-5362doi: 10.1002/ehf2.13626.
Xu, L., Pagano, J., Chow, K., Oudit, G. Y., Haykowsky, M. J., Mikami, Y., Howarth, A. G., White, J. A., Howlett, J. G., Dyck, J. R. B., Anderson, T. J., Ezekowitz, J. A., Thompson, R. B., & Paterson, D. I. (2021). Cardiac remodelling predicts outcome in patients with chronic heart failure. ESC heart failure, 8(6), 5352-5362. https://doi.org/10.1002/ehf2.13626
Xu, Lingyu, et al. "Cardiac remodelling predicts outcome in patients with chronic heart failure." ESC heart failure vol. 8,6 (2021): 5352-5362. doi: https://doi.org/10.1002/ehf2.13626
Xu L, Pagano J, Chow K, Oudit GY, Haykowsky MJ, Mikami Y, Howarth AG, White JA, Howlett JG, Dyck JRB, Anderson TJ, Ezekowitz JA, Thompson RB, Paterson DI. Cardiac remodelling predicts outcome in patients with chronic heart failure. ESC Heart Fail. 2021 Dec;8(6):5352-5362. doi: 10.1002/ehf2.13626. Epub 2021 Sep 26. PMID: 34569184.
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ESC Heart Fail. 2021 Dec;8(6):5352-5362. doi: 10.1002/ehf2.13626. Epub 2021 Sep 26.

Cardiac remodelling predicts outcome in patients with chronic heart failure.

ESC heart failure

Lingyu Xu, Joseph Pagano, Kelvin Chow, Gavin Y Oudit, Mark J Haykowsky, Yoko Mikami, Andrew G Howarth, James A White, Jonathan G Howlett, Jason R B Dyck, Todd J Anderson, Justin A Ezekowitz, Richard B Thompson, D Ian Paterson

Affiliations

  1. Division of Cardiology, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada.
  2. Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
  3. Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada.
  4. Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
  5. Libin Cardiovascular Research Institute, University of Calgary, Calgary, Alberta, Canada.

PMID: 34569184 DOI: 10.1002/ehf2.13626

Abstract

AIMS: Surveillance imaging is often used to detect remodelling, a change in cardiac geometry, and/or function; however, there are limited data in patients with chronic heart failure (HF). We sought to characterize cardiac remodelling in patients with chronic HF and evaluate its association with outcome.

METHODS AND RESULTS: A prospective cohort of patients at risk for HF or with chronic HF underwent cardiac magnetic resonance (CMR) at baseline and 1 year. Ventricular function, volumes, mass, left atrial volume, global longitudinal strain, and myocardial scar were measured. The primary outcome was a composite of death or cardiovascular hospitalization up to 5 years from the 1 year scan. Cox regression was used to identify 1 year CMR predictors of outcome after adjusting for baseline risk. A total of 262 patients (median age 68 years, 57% males) including 96 at risk for HF, 97 with HF and preserved ejection fraction, and 69 with HF and reduced ejection fraction were included. In the patients with HF, 55 events were identified during follow-up. After adjustment for baseline clinical risk, Cox proportion hazard regressions only identified 1 year change in left ventricular (LV) mass index as a CMR predictor of outcome, adjusted hazard ratio 1.21 (1.02, 1.44) per 10% increase, P = 0.031. Cardiac remodelling defined as a 1 year change in LV mass index ≥15% was observed in 35% of patients with HF. Patients with adverse remodelling of LV mass index had more events on Kaplan-Meier analyses compared to those with no remodelling, log-rank P = 0.004 for overall cohort, P = 0.035 for heart failure with preserved ejection fraction and P = 0.035 for heart failure and reduced ejection fraction.

CONCLUSIONS: Cardiac remodelling is common during serial CMR assessment of patients with chronic HF. Change in LV mass predicted long-term outcomes whereas change in left ventricular ejection fraction did not.

© 2021 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.

Keywords: Cardiac remodelling; Chronic heart failure

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