ArticleEuropean radiology2024
Myocardial fibrosis and prognosis in heart failure with preserved ejection fraction: a pooled analysis of 12 cohort studies.
Article in European radiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 10 citations in OpenAlex.
- Association of epicardial fat tissue combined with left ventricular strain with left ventricular fibrosis in obese patients: a cardiac magnetic resonance study.Quantitative imaging in medicine and surgery · 2026Article
- The Role of the Extracellular Volume of the Infarction Zone and the Remote Myocardium in Predicting Systolic Dysfunction After the First Myocardial Infarction.Diagnostics (Basel, Switzerland) · 2026Article
- Myocardial fibrosis in patients with coronary artery disease and diabetes mellitus assessed by cardiovascular magnetic resonance T1 mapping.The international journal of cardiovascular imaging · 2026Article
- Empagliflozin-pirfenidone dual therapy improves cardiac function and structure in a preclinical two-hit HFpEF model.Frontiers in pharmacology · 2026Article
- Beyond cardiac fibroblasts: research advances on understanding and targeting intercellular communication networks in cardiac fibrosis.Frontiers in cardiovascular medicine · 2026Review
- Safety and prognostic value of left ventricular endomyocardial biopsy in dilated cardiomyopathy.European journal of heart failure · 2025Article
- Endogenous assessment of late gadolinium enhancement grey area in patients with chronic myocardial infarction using T1rho mapping.Quantitative imaging in medicine and surgery · 2025Article
- Deciphering myocardial fibrosis: a comprehensive bibliometric analysis of mechanism over the period 1992-2023.Journal of cardiothoracic surgery · 2025Article
- Advancing Cardiovascular Diagnostics: The Expanding Role of CMR in Heart Failure and Cardiomyopathies.Journal of clinical medicine · 2025Review
- Liver fibrosis is associated with left ventricular remodeling: insight into the liver-heart axis.European radiology · 2024Article
- CMR-based cardiac phenotyping in different forms of heart failure.The international journal of cardiovascular imaging · 2024Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
Abstract
objectivesHeart failure with preserved ejection fraction (HFpEF) is a syndrome with significant clinical heterogeneity. Myocardial fibrosis has been considered a common pathological process in the development and progress of HFpEF. This study aimed to consolidate data on the prognostic effect of myocardial fibrosis, evaluated by cardiovascular magnetic resonance (CMR) imaging in patients with HFpEF.
methodsThree medical databases were searched for potentially related articles up to February 28, 2023. Cohort studies reporting associations between myocardial fibrosis and risk of all-cause mortality or composite major adverse cardiac outcomes (MACE) were included. Cardiac fibrosis was evaluated by CMR metrics, including late gadolinium enhancement (LGE) or myocardial extracellular volume (ECV). The hazard ratios (HRs) and 95% confidence intervals (CI) of the outcomes for higher myocardial fibrosis were calculated.
resultsTwelve studies with 2787 patients with HFpEF were included for analysis. After a median follow-up duration of 31.2 months, a higher level of cardiac fibrosis was associated with a significant increase in the risk of MACE (HR = 1.34, 95% CI = 1.14-1.57) and all-cause mortality (HR = 1.74, 95% CI = 1.27-2.39), respectively. Furthermore, the increased risk of outcomes was both observed when cardiac fibrosis was defined according to LGE or ECV, respectively.
conclusionsHigher burden of myocardial fibrosis evaluated by CMR can predict a poor prognosis in patients with HFpEF. Evaluation of LGE or ECV based on CMR could be recommended in these patients for risk stratification and guiding further treatment. CLINICAL RELEVANCE STATEMENT: Inclusion of cardiovascular magnetic resonance examination in the diagnostic and risk-evaluation algorithms in patients with heart failure with preserved ejection fraction should be considered in clinical practice and future studies. KEY POINTS: • Myocardial fibrosis is a common pathological process in heart failure with preserved ejection fraction. • A higher myocardial fibrosis burden on cardiac magnetic resonance predicts a poor prognosis in patients with heart failure with preserved ejection fraction. • Evaluation of myocardial fibrosis may be useful in patients with heart failure with preserved ejection fraction for risk stratification and treatment guidance.
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