Short-Term Changes in Left and Right Ventricular Cardiac Magnetic Resonance Feature Tracking Strain Following Ferric Carboxymaltose in Patients With Heart Failure: A Substudy of the Myocardial-IRON Trial
Por:
del Canto, I, Santas, E, Cardells, I, Minana, G, Palau, P, Llacer, P, Facila, L, Lopez-Vilella, R, Almenar, L, Bodi, V, Lopez-Lereu, MP, Monmeneu, JV, Sanchis, J, Moratal, D, Maceira, AM, de la Espriella, R, Chorro, FJ, Bayes-Genis, A and Nunez, J
Publicada:
5 abr 2022
Resumen:
BACKGROUND: The mechanisms explaining the clinical benefits of ferric carboximaltose (FCM) in patients with heart failure, reduced or intermediate left ventricular ejection fraction, and iron deficiency remain not fully clarified. The Myocardial-IRON trial showed short-term cardiac magnetic resonance (CMR) changes suggesting myocardial iron repletion following administration of FCM but failed to find a significant increase in left ventricular ejection fraction in the whole sample. Conversely, the strain assessment could evaluate more specifically subtle changes in contractility. In this subanalysis, we aimed to evaluate the effect of FCM on the short-term left and right ventricular CMR feature tracking derived strain.
METHODS AND RESULTS: This is a post hoc subanalysis of the double-blind, placebo-controlled, randomized clinical trial that enrolled 53 ambulatory patients with heart failure and left ventricular ejection fraction <50%, and iron deficiency [Myocardial-IRON trial (NCT03398681)]. Three-dimensional left and 2-dimensional right ventricular CMR tracking strain (longitudinal, circumferential, and radial) changes were evaluated before, 7 and 30 days after randomization using linear mixed-effect analysis. The median (interquartile range) age of the sample was 73 years (65-78), and 40 (75.5%) were men. At baseline, there were no significant differences in CMR feature tracking strain parameters across both treatment arms. At 7 days, the only global 3-dimensional left ventricular circumferential strain was significantly higher in the FCM treatment-arm (difference: -1.6%, P=0.001). At 30 days, and compared with placebo, global 3-dimensional left ventricular strain parameters significantly improved in those allocated to FCM treatment-arm [longitudinal (difference: -2.3%, P<0.001), circumferential (difference: -2.5%, P<0.001), and radial (difference: 4.2%, P=0.002)]. Likewise, significant improvements in global right ventricular strain parameters were found in the active arm at 30 days (longitudinal [difference: -3.3%, P=0.010], circumferential [difference: -4.5%, P<0.001], and radial [difference: 4.5%, P=0.027]).
CONCLUSIONS: In patients with stable heart failure, left ventricular ejection fraction <50%, and iron deficiency, treatment with FCM was associated with short-term improvements in left and right ventricular function assessed by CMR feature tracking derived strain parameters.
Filiaciones:
del Canto, I:
Univ Valencia, Hosp Clin Univ Valencia, Cardiol Dept, INCLIVA, Valencia, Spain
CIBER Cardiovasc, Madrid, Spain
Univ Politecn Valencia, Ctr Biomat & Tissue Engn, Valencia, Spain
Santas, E:
Univ Valencia, Hosp Clin Univ Valencia, Cardiol Dept, INCLIVA, Valencia, Spain
CIBER Cardiovasc, Madrid, Spain
Cardells, I:
Hosp Manises, Cardiol Dept, Manises, Spain
Minana, G:
Univ Valencia, Hosp Clin Univ Valencia, Cardiol Dept, INCLIVA, Valencia, Spain
CIBER Cardiovasc, Madrid, Spain
Palau, P:
Univ Valencia, Hosp Clin Univ Valencia, Cardiol Dept, INCLIVA, Valencia, Spain
CIBER Cardiovasc, Madrid, Spain
Llacer, P:
Hosp Manises, Internal Med Dept, Manises, Spain
Facila, L:
Hosp Gen Univ Valencia, Cardiol Dept, Valencia, Spain
Lopez-Vilella, R:
Hosp Gen Univ Valencia, Cardiol Dept, Valencia, Spain
Hosp Univ La Fe Valencia, Cardiol Dept, Valencia, Spain
Almenar, L:
Hosp Univ La Fe Valencia, Cardiol Dept, Valencia, Spain
Bodi, V:
Univ Valencia, Hosp Clin Univ Valencia, Cardiol Dept, INCLIVA, Valencia, Spain
CIBER Cardiovasc, Madrid, Spain
Lopez-Lereu, MP:
Ascires Biomed Grp, Cardiovasc Imaging Unit, Valencia, Spain
Monmeneu, JV:
Ascires Biomed Grp, Cardiovasc Imaging Unit, Valencia, Spain
Sanchis, J:
Univ Valencia, Hosp Clin Univ Valencia, Cardiol Dept, INCLIVA, Valencia, Spain
CIBER Cardiovasc, Madrid, Spain
Moratal, D:
Univ Politecn Valencia, Ctr Biomat & Tissue Engn, Valencia, Spain
Maceira, AM:
Ascires Biomed Grp, Cardiovasc Imaging Unit, Valencia, Spain
de la Espriella, R:
Univ Valencia, Hosp Clin Univ Valencia, Cardiol Dept, INCLIVA, Valencia, Spain
CIBER Cardiovasc, Madrid, Spain
Chorro, FJ:
Univ Valencia, Hosp Clin Univ Valencia, Cardiol Dept, INCLIVA, Valencia, Spain
CIBER Cardiovasc, Madrid, Spain
:
CIBER Cardiovasc, Madrid, Spain
Hosp Badalona Germans Trias & Pujol, Cardiol Dept, Badalona, Spain
Univ Autonoma Barcelona, Barcelona, Spain
Nunez, J:
Univ Valencia, Hosp Clin Univ Valencia, Cardiol Dept, INCLIVA, Valencia, Spain
CIBER Cardiovasc, Madrid, Spain
Green Published, gold
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