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

Subhi J. Al'Aref; Nitesh Gautam; Munthir Mansour; Omar Alqaisi; Tushar Tarun; Subodh Devabhaktuni; Auras Atreya; Raffaele Abete; Giovanni Donato Aquaro; Andrea Baggiano; Andrea Barison; Jan Bogaert; Giovanni Camastra; Samuela Carigi; Nazario Carrabba; Grazia Casavecchia; Stefano Censi; Gloria Cicala; Carlo N. De Cecco; Manuel De Lazzari; Gabriella Di Giovine; Leonardo Calo; Monica Dobrovie; Marta Focardi; Laura Fusini; Nicola Gaibazzi; Annalaura Gismondi; Matteo Gravina; Marco Guglielmo; Chiara Lanzillo; Massimo Lombardi; Valentina Lorenzoni; Jordi Lozano-Torres; Davide Margonato; Chiara Martini; Francesca Marzo; Pier Giorgio Masci; Ambra Masi; Claudio Moro; Giuseppe Muscogiuri; Saima Mushtaq; Alberto Nese; Alessandro Palumbo; Anna Giulia Pavon; Patrizia Pedrotti; Martina Perazzolo Marra; Silvia Pradella; Cristina Presicci; Mark G. Rabbat; Claudia Raineri; Jose’ F. Rodriguez-Palomares; Stefano Sbarbati; U. Joseph Schoepf; Angelo Squeri; Nicola Sverzellati; Rolf Symons; Emily Tat; Mauro Timpani; Giancarlo Todiere; Adele Valentini; Akos Varga-Szemes; Alessandra Volpe; Andrea Igoren Guaricci; Juerg Schwitter; Gianluca Pontone

doi:10.1016/j.ijcard.2024.132709

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

Subhi J. Al'Aref, Nitesh Gautam, Munthir Mansour, Omar Alqaisi, Tushar Tarun, Subodh Devabhaktuni, Auras Atreya, Raffaele Abete, Giovanni Donato Aquaro, Andrea Baggiano, Andrea Barison, Jan Bogaert, Giovanni Camastra, Samuela Carigi, Nazario Carrabba, Grazia Casavecchia, Stefano Censi, Gloria Cicala, Carlo N. De Cecco, Manuel De LazzariGabriella Di Giovine, Leonardo Calo, Monica Dobrovie, Marta Focardi, Laura Fusini, Nicola Gaibazzi, Annalaura Gismondi, Matteo Gravina, Marco Guglielmo, Chiara Lanzillo, Massimo Lombardi, Valentina Lorenzoni, Jordi Lozano-Torres, Davide Margonato, Chiara Martini, Francesca Marzo, Pier Giorgio Masci, Ambra Masi, Claudio Moro, Giuseppe Muscogiuri, Saima Mushtaq, Alberto Nese, Alessandro Palumbo, Anna Giulia Pavon, Patrizia Pedrotti, Martina Perazzolo Marra, Silvia Pradella, Cristina Presicci, Mark G. Rabbat, Claudia Raineri, Jose’ F. Rodriguez-Palomares, Stefano Sbarbati, U. Joseph Schoepf, Angelo Squeri, Nicola Sverzellati, Rolf Symons, Emily Tat, Mauro Timpani, Giancarlo Todiere, Adele Valentini, Akos Varga-Szemes, Alessandra Volpe, Andrea Igoren Guaricci, Juerg Schwitter, Gianluca Pontone^*

^*Corresponding author for this work

Imaging and Biomedical Engineering

Research output: Contribution to journal › Article › peer-review

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.

Original language	English
Article number	132709
Journal	International journal of cardiology
Volume	419
DOIs	https://doi.org/10.1016/j.ijcard.2024.132709
Publication status	Published - 15 Jan 2025

Keywords

Cardiac magnetic resonance
Diabetes mellitus
Heart failure
Renin-angiotensin-aldosterone-system inhibitors

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.ijcard.2024.132709

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Al'Aref, S. J., Gautam, N., Mansour, M., Alqaisi, O., Tarun, T., Devabhaktuni, S., Atreya, A., Abete, R., Aquaro, G. D., Baggiano, A., Barison, A., Bogaert, J., Camastra, G., Carigi, S., Carrabba, N., Casavecchia, G., Censi, S., Cicala, G., De Cecco, C. N., ... Pontone, G. (2025). Clinical parameters of death and heart failure hospitalization in biventricular systolic dysfunction assessed via cardiac magnetic resonance. International journal of cardiology, 419, Article 132709. https://doi.org/10.1016/j.ijcard.2024.132709

@article{d6ad8ae0781b457baa57529bcfde2eee,

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

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",

author = "Al'Aref, {Subhi J.} and Nitesh Gautam and Munthir Mansour and Omar Alqaisi and Tushar Tarun and Subodh Devabhaktuni and Auras Atreya and Raffaele Abete and Aquaro, {Giovanni Donato} and Andrea Baggiano and Andrea Barison and Jan Bogaert and Giovanni Camastra and Samuela Carigi and Nazario Carrabba and Grazia Casavecchia and Stefano Censi and Gloria Cicala and {De Cecco}, {Carlo N.} and {De Lazzari}, Manuel and {Di Giovine}, Gabriella and Leonardo Calo and Monica Dobrovie and Marta Focardi and Laura Fusini and Nicola Gaibazzi and Annalaura Gismondi and Matteo Gravina and Marco Guglielmo and Chiara Lanzillo and Massimo Lombardi and Valentina Lorenzoni and Jordi Lozano-Torres and Davide Margonato and Chiara Martini and Francesca Marzo and Masci, {Pier Giorgio} and Ambra Masi and Claudio Moro and Giuseppe Muscogiuri and Saima Mushtaq and Alberto Nese and Alessandro Palumbo and Pavon, {Anna Giulia} and Patrizia Pedrotti and Marra, {Martina Perazzolo} and Silvia Pradella and Cristina Presicci and Rabbat, {Mark G.} and Claudia Raineri and Rodriguez-Palomares, {Jose{\textquoteright} F.} and Stefano Sbarbati and Schoepf, {U. Joseph} and Angelo Squeri and Nicola Sverzellati and Rolf Symons and Emily Tat and Mauro Timpani and Giancarlo Todiere and Adele Valentini and Akos Varga-Szemes and Alessandra Volpe and Guaricci, {Andrea Igoren} and Juerg Schwitter and Gianluca Pontone",

note = "Publisher Copyright: {\textcopyright} 2024 Elsevier B.V.",

year = "2025",

month = jan,

day = "15",

doi = "10.1016/j.ijcard.2024.132709",

language = "English",

volume = "419",

journal = "International journal of cardiology",

issn = "0167-5273",

publisher = "Elsevier",

}

Al'Aref, SJ, Gautam, N, Mansour, M, Alqaisi, O, Tarun, T, Devabhaktuni, S, Atreya, A, Abete, R, Aquaro, GD, Baggiano, A, Barison, A, Bogaert, J, Camastra, G, Carigi, S, Carrabba, N, Casavecchia, G, Censi, S, Cicala, G, De Cecco, CN, De Lazzari, M, Di Giovine, G, Calo, L, Dobrovie, M, Focardi, M, Fusini, L, Gaibazzi, N, Gismondi, A, Gravina, M, Guglielmo, M, Lanzillo, C, Lombardi, M, Lorenzoni, V, Lozano-Torres, J, Margonato, D, Martini, C, Marzo, F, Masci, PG, Masi, A, Moro, C, Muscogiuri, G, Mushtaq, S, Nese, A, Palumbo, A, Pavon, AG, Pedrotti, P, Marra, MP, Pradella, S, Presicci, C, Rabbat, MG, Raineri, C, Rodriguez-Palomares, JF, Sbarbati, S, Schoepf, UJ, Squeri, A, Sverzellati, N, Symons, R, Tat, E, Timpani, M, Todiere, G, Valentini, A, Varga-Szemes, A, Volpe, A, Guaricci, AI, Schwitter, J & Pontone, G 2025, 'Clinical parameters of death and heart failure hospitalization in biventricular systolic dysfunction assessed via cardiac magnetic resonance', International journal of cardiology, vol. 419, 132709. https://doi.org/10.1016/j.ijcard.2024.132709

TY - JOUR

T1 - Clinical parameters of death and heart failure hospitalization in biventricular systolic dysfunction assessed via cardiac magnetic resonance

AU - Al'Aref, Subhi J.

AU - Gautam, Nitesh

AU - Mansour, Munthir

AU - Alqaisi, Omar

AU - Tarun, Tushar

AU - Devabhaktuni, Subodh

AU - Atreya, Auras

AU - Abete, Raffaele

AU - Aquaro, Giovanni Donato

AU - Baggiano, Andrea

AU - Barison, Andrea

AU - Bogaert, Jan

AU - Camastra, Giovanni

AU - Carigi, Samuela

AU - Carrabba, Nazario

AU - Casavecchia, Grazia

AU - Censi, Stefano

AU - Cicala, Gloria

AU - De Cecco, Carlo N.

AU - De Lazzari, Manuel

AU - Di Giovine, Gabriella

AU - Calo, Leonardo

AU - Dobrovie, Monica

AU - Focardi, Marta

AU - Fusini, Laura

AU - Gaibazzi, Nicola

AU - Gismondi, Annalaura

AU - Gravina, Matteo

AU - Guglielmo, Marco

AU - Lanzillo, Chiara

AU - Lombardi, Massimo

AU - Lorenzoni, Valentina

AU - Lozano-Torres, Jordi

AU - Margonato, Davide

AU - Martini, Chiara

AU - Marzo, Francesca

AU - Masci, Pier Giorgio

AU - Masi, Ambra

AU - Moro, Claudio

AU - Muscogiuri, Giuseppe

AU - Mushtaq, Saima

AU - Nese, Alberto

AU - Palumbo, Alessandro

AU - Pavon, Anna Giulia

AU - Pedrotti, Patrizia

AU - Marra, Martina Perazzolo

AU - Pradella, Silvia

AU - Presicci, Cristina

AU - Rabbat, Mark G.

AU - Raineri, Claudia

AU - Rodriguez-Palomares, Jose’ F.

AU - Sbarbati, Stefano

AU - Schoepf, U. Joseph

AU - Squeri, Angelo

AU - Sverzellati, Nicola

AU - Symons, Rolf

AU - Tat, Emily

AU - Timpani, Mauro

AU - Todiere, Giancarlo

AU - Valentini, Adele

AU - Varga-Szemes, Akos

AU - Volpe, Alessandra

AU - Guaricci, Andrea Igoren

AU - Schwitter, Juerg

AU - Pontone, Gianluca

PY - 2025/1/15

Y1 - 2025/1/15

N2 - 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.

AB - 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.

KW - Cardiac magnetic resonance

KW - Diabetes mellitus

KW - Heart failure

KW - Renin-angiotensin-aldosterone-system inhibitors

UR - http://www.scopus.com/inward/record.url?scp=85208656199&partnerID=8YFLogxK

U2 - 10.1016/j.ijcard.2024.132709

DO - 10.1016/j.ijcard.2024.132709

M3 - Article

AN - SCOPUS:85208656199

SN - 0167-5273

VL - 419

JO - International journal of cardiology

JF - International journal of cardiology

M1 - 132709

ER -

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

Abstract

Keywords

UN SDGs

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