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Cardiac Magnetic Resonance Imaging in Heart Failure With Preserved Ejection Fraction
Daniel S Kikuchi1, Thiago Quinaglia2, Syed Bukhari1
1Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (D.S.K., S.B., K.S., A.G.H.).
Circulation. Cardiovascular Imaging
|August 22, 2025
Summary
Diagnosing heart failure with preserved ejection fraction (HFpEF) is challenging. Cardiac magnetic resonance (CMR) imaging offers new, noninvasive strategies for earlier HFpEF diagnosis and prognosis, including evaluating conditions that mimic HFpEF.
Area of Science:
- Cardiology
- Medical Imaging
- Diagnostic Medicine
Background:
- Heart failure with preserved ejection fraction (HFpEF) is a growing clinical syndrome.
- Diagnosis relies heavily on echocardiography, but challenges remain.
- Emerging therapies necessitate earlier and more accurate diagnosis.
Purpose of the Study:
- To review the role of cardiac magnetic resonance (CMR) in diagnosing and assessing HFpEF.
- To explore CMR's utility in differentiating HFpEF from its mimickers.
- To discuss novel CMR techniques for understanding HFpEF pathophysiology.
Main Methods:
- Review of current literature on CMR in HFpEF.
- Analysis of CMR tissue characterization techniques (T1/T2 mapping, ECV).
- Discussion of novel CMR sequences (spectroscopy, DTI, elastography).
Main Results:
- CMR shows promise for enhancing HFpEF diagnosis and prognosis.
- Parametric mapping aids in evaluating HFpEF mimickers.
- Novel sequences offer insights into HFpEF metabolism and hemodynamics.
Conclusions:
- CMR provides valuable noninvasive diagnostic and prognostic information for HFpEF.
- CMR aids in distinguishing HFpEF from conditions with similar presentations.
- Advanced CMR techniques hold potential for future HFpEF research and clinical application.
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