Methods: 132 patients with mrEF underwent a CMR study between 2012-2018 using a 1,5 T scanner with SSFP and double inversion recovery delayed enhacement images performed after contrast administration. Clinical parameters were recorded after a median follow-up of 762 (230-1315) days. Primary combined endpoint included all-cause death and HF decompensation. Secondary endpoints were NYHA Class, diuretic use and BNP levels. Patients with other cardiac affection rather than mrEF were excluded.
Results: Mean age was 59±12.1 years, 76% were male. Etiology was mostly ischemic (46%), followed by idiopathic (21%) and others (32%). Table 1 shows results for primary endpoint. NYHA Class results are shown on Figure 1. During follow-up, 18% (n=23) were under diuretic treatment. These patients presented higher indexed left atrium volume (LAV) (60.8±5.40ml/m2 vs 49.0±12.0ml/m2, p=0.02) and higher indexed right ventricle end dyastolic volume (IRVEDV) (73.5±6.4ml/m2 vs 64.6±1.6ml/m2, p=0.05). Patients with higher IRVEDV presented a significant correlation with BNP levels (0.55, p<0.01).
Conclusions: mrEF is not a benign condition. CMR higher right ventricle (RV) volumes and less RV EF as well as higher LAV seem to be associated with worse prognosis and may be used in clinical practice to better stratify these patients.