ArticleEuropean heart journal. Cardiovascular Imaging2023
CMR-derived left ventricular intraventricular pressure gradients identify different patterns associated with prognosis in dilated cardiomyopathy.
Article in European heart journal. Cardiovascular Imaging, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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15 citing papers in PubMed, 18 citations in OpenAlex.
- Left ventricular strain and hemodynamic forces from cine CMR for detecting constrictive physiology in pericarditis.Insights into imaging · 2026Article
- Relationship between hemodynamic forces based on CMR and major adverse cardiac events in cancer patients treated with anti-PD-1/PD-L1 immune checkpoint inhibitors.BMC medical imaging · 2026Article
- Prognostic value of left atrial parameters derived from magnetic resonance in dilated cardiomyopathy: a systematic review and meta-analysis.Quantitative imaging in medicine and surgery · 2026Article
- Automated 4D flow MRI pipeline for the quantification of advanced hemodynamic parameters in the left atrium.Scientific reports · 2026Article
- Hemodynamic forces derived from cine cardiac magnetic resonance imaging: technical aspects, applications in various clinical scenarios, and in athlete's heart.Frontiers in cardiovascular medicine · 2026Review
- Force Reversal During Systolic-Diastolic Transition Provides Incremental Prognostic Value over LVEF for Heart Failure After STEMI.Journal of clinical medicine · 2025Article
- Comparison of left ventricular hemodynamic forces measured by transthoracic echocardiography and cardiac magnetic resonance imaging in healthy adults.Scientific reports · 2025Article
- Left ventricular flow dynamics by cardiac imaging techniques in heart failure patients: state of the art.Cardiovascular ultrasound · 2025Review
- Cardiac Functional Assessment by Magnetic Resonance Imaging.Cardiology discovery · 2024Review
- Differences in cardiac mechanics assessed by left ventricular hemodynamic forces in athletes and patients with hypertension.Scientific reports · 2024Article
- Assessing cardiac mechanics through left ventricular haemodynamic forces.European heart journal. Imaging methods and practice · 2024Review
- Echocardiography-Derived Hemodynamic Forces Are Associated with Clinical Outcomes in Patients with Non-Ischemic Dilated Cardiomyopathy.Journal of clinical medicine · 2024Article
- Unravelling the intricacies of left ventricular haemodynamic forces: age and gender-specific normative values assessed by cardiac MRI in healthy adults.European heart journal. Cardiovascular Imaging · 2024Article
- Cardiovascular magnetic resonance imaging-derived intraventricular pressure gradients in ST-segment elevation myocardial infarction: a long-term follow-up study.European heart journal. Imaging methods and practice · 2024Article
- Characteristics and prognostic value of cardiovascular magnetic resonance imaging-derived left ventricular hemodynamics in pulmonary arterial hypertension.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic ResonanceArticle
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Authors and funding
8 authors at 3 institutions in 4 countries.
Funding
Abstract
aimsLeft ventricular (LV) blood flow is determined by intraventricular pressure gradients (IVPG). Changes in blood flow initiate remodelling and precede functional decline. Novel cardiac magnetic resonance (CMR) post-processing LV-IVPG analysis might provide a sensitive marker of LV function in dilated cardiomyopathy (DCM). Therefore, the aim of our study was to evaluate LV-IVPG patterns and their prognostic value in DCM. METHODS AND
resultsLV-IVPGs between apex and base were measured on standard CMR cine images in DCM patients (n = 447) from the Maastricht Cardiomyopathy registry. Major adverse cardiovascular events, including heart failure hospitalisations, life-threatening arrhythmias, and sudden/cardiac death, occurred in 66 DCM patients (15%). A temporary LV-IVPG reversal during systolic-diastolic transition, leading to a prolonged transition period or slower filling, was present in 168 patients (38%). In 14%, this led to a reversal of blood flow, which predicted outcome corrected for univariable predictors [hazard ratio (HR) = 2.57, 95% confidence interval (1.01-6.51), P = 0.047]. In patients without pressure reversal (n = 279), impaired overall LV-IVPG [HR = 0.91 (0.83-0.99), P = 0.033], systolic ejection force [HR = 0.91 (0.86-0.96), P < 0.001], and E-wave decelerative force [HR = 0.83 (0.73-0.94), P = 0.003] predicted outcome, independent of known predictors (age, sex, New York Heart Association class ≥ 3, LV ejection fraction, late gadolinium enhancement, LV-longitudinal strain, left atrium (LA) volume-index, and LA-conduit strain).
conclusionPressure reversal during systolic-diastolic transition was observed in one-third of DCM patients, and reversal of blood flow direction predicted worse outcome. In the absence of pressure reversal, lower systolic ejection force, E-wave decelerative force (end of passive LV filling), and overall LV-IVPG are powerful predictors of outcome, independent of clinical and imaging parameters.
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