Phenotyping heart failure with preserved ejection fraction : focus on markers of fibrosis (extracellular volume by cMR and biomarkers) and their prognostic impact

Heart failure is a frequent cause of hospitalization worldwide. The prevalence of heart failure is approximatively 10% in patients above 70 years old. The proportion of patients with heart failure with preserved ejection fraction is about 50% and this prevalence is set to rise considerably due to the higher prevalence of risk factors in our aging population. Diagnosis of HFpEF is challenging. It’s obvious in patient with overt congestion but evaluation in euvolemic dyspneic patients is a greater challenge. Cardiovascular imaging plays a central role in the diagnosis and evaluation of HFpEF, particularly echocardiography, the method of choice, which allows for assessment of cardiac structure, function, and hemodynamics (accuracy, availability, safety and cost). Pathophysiology is very complex, with an important etiological role of myocardial extracellular fibrosis. The main objective of our work was to better understand the role of imaging in HFpEF, especially analysis of fibrosis by cardiac magnetic resonance or biomarker and its associations with other clinical/imaging parameters and with the outcomes.(MED - Sciences médicales) -- UCL, 202