A sex-specific approach to estimate left ventricular filling pressure using cardiac magnetic resonance imaging may improve heart failure diagnosis precision, according to a study published in the European Heart Journal Open.
The study included a derivation cohort of 835 patients (60% female) and a validation cohort of 454 patients (36% female) with confirmed heart failure (HF). The researchers developed sex-specific models incorporating left ventricular mass and left atrial volume to estimate left ventricular filling pressure (LVFP), measured as pulmonary capillary wedge pressure (PCWP).
Key findings:
- Generic cardiac magnetic resonance (CMR)-derived PCWP values were significantly higher in males compared with females (14.7 ± 4.0 vs. 13.0 ± 3.0 mmHg, P < 0.001).
- The sex-specific model resolved this bias, with no significant difference in PCWP between sexes (14.1 ± 3 vs. 13.8 mmHg, P = 0.3).
- In the validation cohort, the sex-specific CMR-derived PCWP model outperformed the generic model in predicting HF hospitalization (hazard ratio 3.9, P = 0.0002) and major adverse cardiovascular events (hazard ratio 2.5, P = 0.001) over a mean follow-up of 2.4 ± 1.2 years.
The study demonstrated that incorporating sex-specific factors in CMR-based LVFP estimation can improve the accuracy and prognostic value of this non-invasive assessment, noted study investigators. Further research is needed to validate the sex-specific model in various HF etiologies and patient populations.
One author disclosed being a clinical advisor for Pie Medical Imaging and Medis Medical Imaging. All other authors had no conflicts of interest to declare.
