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Hemodynamic force analysis is not ready for clinical trials on HFpEF

Arvidsson, Per M LU ; Nelsson, Anders LU ; Magnusson, Martin LU orcid ; Smith, J Gustav ; Carlsson, Marcus LU and Arheden, Håkan LU (2022) In Scientific Reports 12.
Abstract

Hemodynamic force analysis has been proposed as a novel tool for early detection of subclinical systolic dysfunction in heart failure with preserved ejection fraction (HFpEF). Here we investigated the ability of hemodynamic forces to discriminate between healthy subjects and heart failure patients with varying degrees of systolic dysfunction. We studied 34 controls, 16 HFpEF patients, and 25 heart failure patients with mid-range (HFmrEF) or reduced ejection fraction (HFrEF) using cardiac magnetic resonance with acquisition of cine images and 4D flow at 1.5 T. The Navier-Stokes equation was used to compute global left ventricular hemodynamic forces over the entire cardiac cycle. Forces were analyzed for systole, diastole, and the entire... (More)

Hemodynamic force analysis has been proposed as a novel tool for early detection of subclinical systolic dysfunction in heart failure with preserved ejection fraction (HFpEF). Here we investigated the ability of hemodynamic forces to discriminate between healthy subjects and heart failure patients with varying degrees of systolic dysfunction. We studied 34 controls, 16 HFpEF patients, and 25 heart failure patients with mid-range (HFmrEF) or reduced ejection fraction (HFrEF) using cardiac magnetic resonance with acquisition of cine images and 4D flow at 1.5 T. The Navier-Stokes equation was used to compute global left ventricular hemodynamic forces over the entire cardiac cycle. Forces were analyzed for systole, diastole, and the entire heartbeat, with and without normalization to left ventricular volume. Volume-normalized hemodynamic forces demonstrated significant positive correlation with EF (r2 = 0.47, p < 0.0001) and were found significantly lower in heart failure with reduced ejection fraction compared to controls (p < 0.0001 for systole and diastole). No difference was seen between controls and HFpEF (p > 0.34). Non-normalized forces displayed no differences between controls and HFpEF (p > 0.24 for all analyses) and did not correlate with EF (p = 0.36). Left ventricular hemodynamic force analysis, whether indexed to LV volumes or not, is not ready for clinical trials on HFpEF assessment.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Scientific Reports
volume
12
article number
4017
publisher
Nature Publishing Group
external identifiers
  • pmid:35256713
  • scopus:85125970860
ISSN
2045-2322
DOI
10.1038/s41598-022-08023-4
project
Non-invasive imaging in heart failure - early predictions and outcomes
Advanced CMR analysis: from pixels to physiology
language
English
LU publication?
yes
additional info
© 2022. The Author(s).
id
6e52138d-6927-4518-a140-1ba71a266206
date added to LUP
2022-03-11 09:37:46
date last changed
2024-06-17 08:34:30
@article{6e52138d-6927-4518-a140-1ba71a266206,
  abstract     = {{<p>Hemodynamic force analysis has been proposed as a novel tool for early detection of subclinical systolic dysfunction in heart failure with preserved ejection fraction (HFpEF). Here we investigated the ability of hemodynamic forces to discriminate between healthy subjects and heart failure patients with varying degrees of systolic dysfunction. We studied 34 controls, 16 HFpEF patients, and 25 heart failure patients with mid-range (HFmrEF) or reduced ejection fraction (HFrEF) using cardiac magnetic resonance with acquisition of cine images and 4D flow at 1.5 T. The Navier-Stokes equation was used to compute global left ventricular hemodynamic forces over the entire cardiac cycle. Forces were analyzed for systole, diastole, and the entire heartbeat, with and without normalization to left ventricular volume. Volume-normalized hemodynamic forces demonstrated significant positive correlation with EF (r2 = 0.47, p &lt; 0.0001) and were found significantly lower in heart failure with reduced ejection fraction compared to controls (p &lt; 0.0001 for systole and diastole). No difference was seen between controls and HFpEF (p &gt; 0.34). Non-normalized forces displayed no differences between controls and HFpEF (p &gt; 0.24 for all analyses) and did not correlate with EF (p = 0.36). Left ventricular hemodynamic force analysis, whether indexed to LV volumes or not, is not ready for clinical trials on HFpEF assessment.</p>}},
  author       = {{Arvidsson, Per M and Nelsson, Anders and Magnusson, Martin and Smith, J Gustav and Carlsson, Marcus and Arheden, Håkan}},
  issn         = {{2045-2322}},
  language     = {{eng}},
  month        = {{03}},
  publisher    = {{Nature Publishing Group}},
  series       = {{Scientific Reports}},
  title        = {{Hemodynamic force analysis is not ready for clinical trials on HFpEF}},
  url          = {{http://dx.doi.org/10.1038/s41598-022-08023-4}},
  doi          = {{10.1038/s41598-022-08023-4}},
  volume       = {{12}},
  year         = {{2022}},
}