TY - JOUR
T1 - Short-Term Changes in Left and Right Ventricular Cardiac Magnetic Resonance Feature Tracking Strain Following Ferric Carboxymaltose in Patients With Heart Failure :
T2 - A Substudy of the Myocardial-IRON Trial
AU - del Canto, Irene
AU - Santas, Enrique
AU - Cardells, Ingrid
AU - Miñana, Gema
AU - Palau, Patricia
AU - Llàcer, Pau
AU - Fácila, Lorenzo
AU - López-Vilella, Raquel
AU - Almenar Bonet, Luis
AU - Bodi, Vicente
AU - López-Lereu, Maria P.
AU - Monmeneu, Jose V.
AU - Sanchis, Juan
AU - Moratal, David
AU - Maceira, Alicia M.
AU - De la Espriella, Rafael
AU - Chorro, Francisco J.
AU - Bayés-Genís, Antoni
AU - Núñez, Julio
PY - 2022
Y1 - 2022
N2 - 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. 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]). 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. URL: ; Unique identifier: NCT03398681.
AB - 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. 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]). 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. URL: ; Unique identifier: NCT03398681.
KW - CMR feature tracking
KW - Ferric carboxymaltose
KW - Heart failure
KW - Iron deficiency
KW - Ventricular strain
KW - Heart Failure
KW - Magnetic Resonance Imaging (MRI)
U2 - 10.1161/JAHA.121.022214
DO - 10.1161/JAHA.121.022214
M3 - Article
C2 - 35301854
SN - 2047-9980
VL - 11
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
ER -