Heart failure with preserved ejection fraction (HFpEF) accounts for almost one-half of all heart failure (HF) patients and continues to increase in prevalence. While mortality with heart failure with reduced ejection fraction (HFrEF) has decreased over the past few decades with use of evidence-based HFrEF therapy, mortality related to heart failure with HFpEF has not changed significantly over the same time period. The combination of poor prognosis and lack of effective treatment options creates a pressing need for novel strategies for better patient characterization. We conducted a systematic review to evaluate the prognostic value of cardiac magnetic resonance (CMR)-derived T1 relaxation time and extracellular volume fraction (ECV) in HFpEF patients. PubMed, Embase, and Cochrane Central were searched for relevant studies. The primary outcomes of interest were hospitalization for HF and all-cause mortality. Five studies with 2741 patients were included. Four studies reported correlation of outcomes with ECV, 2 studies reported correlation of outcomes with native T1 time, and 1 study reported correlation of outcomes with post-contrast T1 time. All five studies showed significant correlation of CMR-derived parameters with adverse outcomes including event-free survival to cardiac event, all cause, and cardiac mortality. CMR-determined ECV is strongly correlated with adverse outcomes in HFpEF cohorts.

中文翻译：

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T1映射参数在射血分数保留的心力衰竭中的预后意义：系统评价。

射血分数保留的心力衰竭 (HFpEF) 几乎占所有心力​​衰竭 (HF) 患者的一半，并且患病率继续增加。虽然在过去的几十年中，随着使用循证 HFrEF 治疗，射血分数降低的心力衰竭 (HFrEF) 的死亡率有所下降，但同期与 HFpEF 心力衰竭相关的死亡率并没有显着变化。预后不良和缺乏有效的治疗选择相结合，迫切需要新的策略来更好地表征患者。我们进行了一项系统评价，以评估心脏磁共振 (CMR) 衍生的 T1 弛豫时间和细胞外体积分数 (ECV) 在 HFpEF 患者中的预后价值。检索了 PubMed、Embase 和 Cochrane Central 的相关研究。感兴趣的主要结果是因 HF 住院和全因死亡率。包括 2741 名患者的五项研究。四项研究报告结果与 ECV 相关，2 项研究报告结果与自然 T1 时间相关，1 项研究报告结果与对比后 T1 时间相关。所有五项研究均显示 CMR 衍生参数与不良结局（包括心脏事件的无事件生存率、全因和心脏死亡率）之间存在显着相关性。CMR 确定的 ECV 与 HFpEF 队列中的不良结果密切相关。和 1 项研究报告了结果与对比后 T1 时间的相关性。所有五项研究均显示 CMR 衍生参数与不良结局（包括心脏事件的无事件生存率、全因和心脏死亡率）之间存在显着相关性。CMR 确定的 ECV 与 HFpEF 队列中的不良结果密切相关。和 1 项研究报告了结果与对比后 T1 时间的相关性。所有五项研究均显示 CMR 衍生参数与不良结局（包括心脏事件的无事件生存率、全因和心脏死亡率）之间存在显着相关性。CMR 确定的 ECV 与 HFpEF 队列中的不良结果密切相关。