Atrial dysfunction: a contrast-free marker for HFpEF in obese diabetics—insights from comprehensive cardiac magnetic resonance (CMR) and serum biomarker analyses
Authors' conclusion
CMR markers of diffuse fibrosis and microvascular dysfunction may not differentiate HFpEF from obese or diabetic controls. However, left atrial function assessment may evolve to be a reproducible and practical CMR marker, effectively distinguishing HFpEF independent of fibrotic remodeling.
Study context
- Population
- Obese/overweight participants (mean age 64 ± 8 years, 23% females)
- Participants
- 35 participants
- Comparison
- HFpEF with T2DM vs obese/overweight T2DM vs healthy controls
- T2DMn = 16
- HFpEFn = 13
- Healthy controlsn = 6reference
Primary result
As reported in the abstract
Independent discriminators of HFpEF (multivariable regression), OR per unit increase
Left atrial (LA) maximum volume, OR
1.13
95% CI 1.05–1.28
LA reservoir strain, OR
0.71
95% CI 0.44–0.89
LA conduit strain, OR
0.57
95% CI 0.32–0.82
LA booster strain, OR
0.70
95% CI 0.48–0.89
Further findings
| Outcome | HFpEF | P value |
|---|---|---|
| Galectin-3HFpEF vs Obese controls · within normal limits | 16.1 ± 3.8 ng/ml | P = 0.011 |
| Pentraxin-3HFpEF vs Obese controls | 0.84 ± 0.67 ng/ml | P = 0.031 |
- Galectin-3: Obese controls 10.6 ± 3.7 ng/ml
- Pentraxin-3: Obese controls 0.21 ± 0.05 ng/ml
- Pentraxin-3: within normal limits; only moderate correlations with CMR metrics
Myocardial perfusion reserve (MPR) and ECV
- No differences in MPR nor ECV between the groups
Inter-study reproducibility (ICC)
- MPR
- 0.94
- LA reservoir strain
- 0.84
- Serum biomarkers
- 0.087-0.93
Original publication
Atrial dysfunction: a contrast-free marker for HFpEF in obese diabetics—insights from comprehensive CMR and serum biomarker analyses. Cardiovasc Diabetol. Published 18 June 2025. doi:10.
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