AI-Enhanced CV MRI Predicts Heart Failure Risk, Study Finds Fivefold Increased Risk with High Heart Pressure

The study, led by Ross Thomson from Queen Mary University of London and senior author Pankaj Garg, MD, from the University of East Anglia in Norwich, found that individuals with elevated heart pressure, as measured by MRI, faced a fivefold increased risk of developing heart failure within six years.

Garg highlighted in a statement from the University of East Anglia that a key finding of the study is the ability of MRI-derived pressure measurements to accurately predict the likelihood of developing heart failure.

The group explained that the rising prevalence of HF is partly attributed to an aging population. A common indicator of this condition is elevated left ventricular filling pressure, which is typically assessed through pulmonary capillary wedge pressure (PCWP) via cardiac catheterization. Cardiovascular magnetic resonance (CMR) imaging holds potential for non-invasive estimation of PCWP. However, its prognostic value at the population level is still uncertain. Additionally, the connection between CMR-modelled PCWP and well-established cardiovascular risk factors has yet to be thoroughly defined.

To fill this knowledge gap, the researchers aimed to investigate the prognostic value of CMR-modelled PCWP at the population level.

For this purpose, data from the imaging substudy of the UK Biobank—a substantial prospective population-based cohort study—were utilized. CMR-modelled PCWP was calculated using a model that includes left atrial volume, left ventricular mass, and sex.

Logistic regression was employed to investigate the relationships between conventional cardiovascular risk factors and elevated CMR-modelled PCWP (≥15 mmHg). Additionally, Cox regression was used to assess the effects of standard risk factors and CMR-modelled PCWP on heart failure and major adverse cardiovascular events (MACE).

The following were the key findings of the study:

• Data from 39,163 participants were included in the study. The median age of all participants was 64 years, and 47% were males.
• Clinical characteristics independently associated with raised CMR-modelled PCWP included hypertension [odds ratio (OR) 1.57], body mass index (BMI) [OR 1.57], male sex (OR 1.37), age (OR 1.33) and regular alcohol consumption (OR 1.10).
• After adjusting for potential confounders, CMR-modelled PCWP was independently associated with incident HF [hazard ratio (HR) 2.91] and MACE (HR 1.48).

"The findings showed that elevated CMR-modelled PCWP is an independent predictor of incident heart failure and MACE. It is recommended to include CMR-modelled PCWP in routine CMR reports to aid in HF diagnosis and management," the researchers concluded.

Reference:

Thomson, R. J., Grafton-Clarke, C., Matthews, G., Swoboda, P. P., Swift, A. J., Frangi, A., Petersen, S. E., Aung, N., & Garg, P. Risk factors for raised left ventricular filling pressure by cardiovascular magnetic resonance: Prognostic insights. ESC Heart Failure. https://doi.org/10.1002/ehf2.15011