247 HEPATIC T1-TIME, CARDIAC STRUCTURE, FUNCTION AND CARDIOVASCULAR OTUCOMES IN PATIENTS WITH HEART FAILURE WITH REDUCED EJECTION FRACTION UNDERGOING CARDIAC MAGNETIC RESONANCE IMAGING

Abstract

Abstract Aim Liver damage is frequently encountered in patients with cardiovascular (CV) disease, due to congestion or metabolic dysfunction-associated fatty liver disease (MAFLD). It has been shown that liver disease is associated with worse outcomes in patients with CV disease. Nevertheless, the association of liver disease with cardiac structure and function and CV events in patients with heart failure and reduced ejection fraction (HFrEF) is poorly known. Methods We retrospectively enrolled consecutive patients with HFrEF undergoing Cardiac Magnetic Resonance (CMR) Imaging. In addition to standard cardiac T1-mapping, 3 regions of interest were also defined at the liver parenchyma. Patients were stratified according to hepatic T1 mapping. Linear regression analysis adjusted for demographics and clinical characteristics was performed to cross-sectionally examine the association between hepatic T1-time on CMR and measures of cardiac structure and function. The Kaplan-Meier survival and Cox regression analyses were performed to prospectively investigate the association between hepatic T1-time and the composite adverse outcome of hospitalization for HF or all-cause death. Results Overall, 106 HFrEF patients were included in the study (mean age 56 ± 14 years, 75% male). Mean hepatic T1-time was 558 ± 70 ms. In logistic regression analysis, left-ventricle (LV) end-diastolic volume (EDV) (p = 0.027), left atrial volume (LAV) (p = 0.015), right-ventricle (RV) EDV (p < 0.001) and RVEF (p = 0.035) were positively associated with hepatic T1-time. Over a mean follow-up of 5 ± 2 years, 32 patients (30%) experienced the composite outcome at a rate of 6.7 per 100 person-year. In Cox regression analysis, higher hepatic T1-time was independently associated with an increased risk of developing the composite outcome (adjusted-hazard ratio 1.07, 95% confidence interval: 1.01–1.12, p = 0.011). In particular, patients with a hepatic T1-time ≥558 ms had a higher risk of adverse outcomes compared to those with a hepatic T1-time <558 ms (log-rank p = 0.02). Conclusion Among HFrEF patients undergoing CMR, higher hepatic T1-time was significantly associated with poorer measures of cardiac size and function. Hepatic T1-time was also significantly associated with higher rates of hospitalization for HF or all-cause-mortality. This parameter may be useful to stratify HFrEF patients at risk of adverse cardiovascular outcomes.