Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jan 15:419:132709.
doi: 10.1016/j.ijcard.2024.132709. Epub 2024 Nov 7.

Clinical parameters of death and heart failure hospitalization in biventricular systolic dysfunction assessed via cardiac magnetic resonance

Subhi J Al'Aref  1 , Nitesh Gautam  2 , Munthir Mansour  2 , Omar Alqaisi  2 , Tushar Tarun  1 , Subodh Devabhaktuni  1 , Auras Atreya  1 , Raffaele Abete  3 , Giovanni Donato Aquaro  4 , Andrea Baggiano  5 , Andrea Barison  4 , Jan Bogaert  6 , Giovanni Camastra  7 , Samuela Carigi  8 , Nazario Carrabba  9 , Grazia Casavecchia  10 , Stefano Censi  11 , Gloria Cicala  12 , Carlo N De Cecco  13 , Manuel De Lazzari  14 , Gabriella Di Giovine  3 , Leonardo Calo  15 , Monica Dobrovie  6 , Marta Focardi  16 , Laura Fusini  17 , Nicola Gaibazzi  18 , Annalaura Gismondi  16 , Matteo Gravina  19 , Marco Guglielmo  20 , Chiara Lanzillo  15 , Massimo Lombardi  21 , Valentina Lorenzoni  22 , Jordi Lozano-Torres  23 , Davide Margonato  3 , Chiara Martini  24 , Francesca Marzo  8 , Pier-Giorgio Masci  25 , Ambra Masi  26 , Claudio Moro  27 , Giuseppe Muscogiuri  28 , Saima Mushtaq  29 , Alberto Nese  30 , Alessandro Palumbo  12 , Anna Giulia Pavon  31 , Patrizia Pedrotti  26 , Martina Perazzolo Marra  14 , Silvia Pradella  32 , Cristina Presicci  12 , Mark G Rabbat  33 , Claudia Raineri  34 , Jose' F Rodriguez-Palomares  23 , Stefano Sbarbati  35 , U Joseph Schoepf  36 , Angelo Squeri  11 , Nicola Sverzellati  37 , Rolf Symons  6 , Emily Tat  38 , Mauro Timpani  39 , Giancarlo Todiere  4 , Adele Valentini  40 , Akos Varga-Szemes  39 , Alessandra Volpe  29 , Andrea Igoren Guaricci  41 , Juerg Schwitter  42 , Gianluca Pontone  43
Affiliations

Clinical parameters of death and heart failure hospitalization in biventricular systolic dysfunction assessed via cardiac magnetic resonance

Subhi J Al'Aref et al. Int J Cardiol. .

Abstract

Aims: While factors associated with adverse events are well elucidated in setting of isolated left ventricular dysfunction, clinical and imaging-based prognosticators of adverse outcomes are lacking in context of biventricular dysfunction. The purpose of this study was to establish role of clinical variables in prognosis of biventricular heart failure (HF), as assessed by cardiac magnetic resonance imaging.

Methods: Study cohort consisted of 840 patients enrolled in DERIVATE registry with coexisting CMR-derived right ventricular (RV) and left ventricular (LV) dysfunction, as defined by RV and LV ejection fractions ≤45 % and ≤ 50 %, respectively. The primary objective was to identify factors associated with adverse long-term outcomes, defined as composite of all-cause death and HF hospitalizations (DHFH). Kaplan-Meir curves were plotted for survival analysis. Cox proportional hazard models were constructed to estimate adjusted hazard ratios (aHRs) and associated 95 % confidence intervals for clinical variables and their correlation with adverse events.

Results: Mean age was 61.0 years; 83.1 % were male, 26.6 % had diabetes mellitus (DM), and 45.9 % had non-ischemic cardiomyopathy. At median follow-up of 2 years, DHFH occurred in 32.5 % of the cohort. Kaplan-Meir analysis showed higher rate of DHFH in patients with DM (35.2 % vs. 22.6 %, p < 0.001). Multivariate Cox regression analysis showed that DM was independently associated with DHFH (aHR 1.61 [95 % CI: 1.15-2.25]; p = 0.003). Importantly, ACE-inhibitor/ARB usage in patients with DM was associated with significant reduction in DHFH (aHR 0.53 [95 % CI: 0.31-0.90]; p = 0.02).

Conclusion: In patients with biventricular HF, DM was a strong predictor of DHFH, with ACE-inhibitor/ARB usage having cardioprotective effect.

Keywords: Cardiac magnetic resonance; Diabetes mellitus; Heart failure; Renin-angiotensin-aldosterone-system inhibitors.

PubMed Disclaimer

Conflict of interest statement

Declaration of competing interest Subhi J. Al’Aref is supported by NIH: National Institutes of Health, USA 2R01 HL12766105 & 1R21 EB030654 and receives royalty fees from Elsevier. Carlo De Cecco received grant from Siemens. Gianluca Pontone received institutional fees by General Electric, Bracco, Heartflow, Medtronic, Bayer, Bhoeringher. Juerg Schwitter received research support by Bayer Healthcare Switzerland. U. Joseph Schoepf received grant by Astellas, Bayer, General Electric, and Siemens Healthcare, personal fees by Guerbet, speaking honorarium by Heartflow. Akos Varga-Szemes received grant from Siemens Healthcare and personal fees from Elucid Bioimaging. The other authors have no conficts of interestes relevant to this paper.

MeSH terms