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Myocardial Fibrosis in Patients with HFpEF

JAMA Cardiol; ePub 2017 Aug 2; Schelbert, et al

Among many changes in evolving heart failure with preserved ejection fraction (HFpEF), myocardial fibrosis is similarly prevalent in those with or at risk for HFpEF and is associated with disease severity and adverse outcomes, a recent study found. The observational cohort study from June 1, 2010, to September 17, 2015, with follow-up until December 14, 2015, investigated whether MF is similarly prevalent in both those with HFpEF and those at risk for HFpEF, similarly associating with disease severity and outcomes. MF was quantified by extracellular volume (ECV) cardiovascular magnetic resonance (CMR) measures. Main outcome was baseline brain-type natriuretic peptide (BNP) and subsequent hospitalization for HF or death. Researchers found:

  • Of 1,174 patients identified, 410 were at risk for or with a current diagnosis of HFpEF.
  • Patients either at risk for HFpEF or with HFpEF demonstrated similarly higher prevalence/extent of MF and worse prognosis vs patients with no HFpEF.
  • Among those at risk for HFpEF or with HFpEF, the actual diagnosis of HFpEF was not associated with significant differences in MF or prognosis.
  • MF was prevalent and associated with disease severity and adverse outcomes.

Citation:

Schelbert EB, Fridman Y, Wong TC, et al. Temporal relation between myocardial fibrosis and heart failure with preserved ejection fraction. Association with baseline disease severity and subsequent outcome. [Published online ahead of print August 2, 2017]. JAMA Cardiol. doi:10.1001/jamacardio.2017.2511.