CMR in the Evaluation of Diastolic Dysfunction and Phenotyping of HFpEF: Current Role and Future Perspectives

Area of Science:

• Cardiology
• Medical Imaging
• Cardiovascular Disease

Background:

• Heart failure with preserved ejection fraction (HFpEF) poses diagnostic challenges due to patient heterogeneity and limited treatments.
• Echocardiography is crucial for diastolic function assessment, comparable in importance to systolic function evaluation.
• Cardiac magnetic resonance (CMR) imaging is emerging as a powerful, radiation-free tool for comprehensive cardiac assessment.

Purpose of the Study:

• To explore the utility of CMR imaging in assessing diastolic function in HFpEF.
• To highlight CMR's potential for early detection of myocardial disease and improved diagnosis.
• To review various CMR-derived diastolic functional indices and their clinical relevance.

Main Methods:

• Review of studies examining CMR-derived diastolic functional indices.
• Assessment of techniques including transmitral/pulmonary venous velocities, myocardial tagging, and feature tracking.
• Evaluation of CMR's high-resolution imaging for global and regional functional analysis.

Main Results:

• CMR provides a radiation-free, high-resolution imaging modality with an unrestricted field of view.
• Tissue characterization via CMR offers early markers for myocardial disease detection.
• Various CMR techniques demonstrate potential for robust diastolic function assessment.

Conclusions:

• CMR imaging is a valuable tool for evaluating diastolic function in HFpEF.
• CMR's ability to provide detailed functional and tissue characterization aids in diagnosis and management.
• The clinical application of imaging-based diastolic function indices across modalities is increasingly recognized.