A study led by the University of East Anglia (UEA) and Queen Mary University of London in the U.K. shows that the use of magnetic resonance imaging (MRI) to measure pressure in blood vessels around the heart is a good predictor of heart failure risk.
The researchers report that higher than normal MRI-detected pulmonary capillary wedge pressure (PCWP) corresponded to a threefold increased risk of heart failure in a group of almost 40,000 people from the U.K. Biobank.
As reported in the journal ESC Heart Failure, the investigators also looked at health factors linked to raised PCWP. They found that being over the age of 70 years, having obesity or high blood pressure, drinking alcohol regularly, and being male were all linked to high PCWP.
“By combining these factors, we developed a model to predict individual heart failure risk. This advancement enables prevention, early detection, and treatment … which could save many lives,” said co-lead author Nay Aung, MD, a researcher and cardiologist from the William Harvey Research Institute at Queen Mary University of London, in a press statement.
Heart failure, which occurs when the muscle in the heart gradually loses the ability to pump blood properly, impacts around 6.5 million Americans. It can be life-threatening, with around 8.5% of heart disease deaths in the U.S. caused directly by this condition.
Raised left ventricular filling pressure in the heart is a sign of heart failure, which can be estimated using a measure of PCWP. This has traditionally been measured invasively using a technique known as cardiac catheterization.
Ultrasound imaging can be used to assess these measures, but calculations are needed to translate echocardiographic imaging into an estimate of left ventricular filling pressure and there is some doubt about accuracy of these estimates.
MRI assessment was previously shown by the same authors to produce accurate PCWP readings, but has not been previously assessed as a predictive measure of heart failure.
In this study, 39,163 participants of the U.K. Biobank were included in the analysis. Over roughly 6 years of follow-up, raised PCWP (at or over 15 mmHg) was linked to a 2.9-fold increased risk for a new diagnosis of heart failure and a 1.5-fold increased risk for major adverse cardiovascular events after adjusting for potentially confounding factors.
The team also found that hypertension, increased body mass index (per standard deviation increase), male sex, older age (per 10-year increase), and regular alcohol consumption (at least three times a week) increased the chance of having raised PCWP by 57%, 57%, 37%, 33%, and 10%, respectively.
“Heart failure is a lethal condition resulting from rising pressures. One of the most significant findings of this study is that MRI-derived pressure measurements can reliably predict if an individual will develop heart failure,” said co-lead author Pankaj Garg, MD, PhD, a clinician and researcher from UEA’s Norwich Medical School. “This breakthrough suggests that heart MRI could potentially replace invasive diagnostic tests.”
