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  3. 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.

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.

Fecha de publicación: Fecha Ahead of Print:

Autores de INCLIVA

Participantes ajenos a INCLIVA

  • Cardells, I
  • Palau, P
  • Llacer, P
  • Facila, L
  • Lopez-Vilella, R
  • Almenar, L
  • Lopez-Lereu, MP
  • Monmeneu, JV
  • Moratal, D
  • Maceira, AM
  • Bayes-Genis, A
  • Myocardial-IRON Investigators

Grupos y Plataformas de I+D+i

Abstract

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. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT03398681.

Datos de la publicación

ISSN/ISSNe:
2047-9980, 2047-9980

Journal of the American Heart Association  WILEY

Tipo:
Article
Páginas:
-
PubMed:
35301854

Citas Recibidas en Web of Science: 11

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Keywords

  • CMR feature tracking; ferric carboxymaltose; heart failure; iron deficiency; ventricular strain

Campos de Estudio

Financiación

INSTITUTO SALUD CARLOS III (2017/216)
INSTITUTO SALUD CARLOS III (CB16/11/00420)

Proyectos y Estudios Clínicos

INCORPORACIÓN DE NUEVAS ÁREAS TEMÁTICAS Y NUEVOS GRUPOS AL CONSORCIO CIBER

Investigador Principal: JUAN SANCHIS FORES

CB16/11/00420 . INSTITUTO SALUD CARLOS III

PLATAFORMA DE UNIDADES DE INVESTIGACION CLINICA Y ENSAYOS CLINICOS. PT17/0017/0003

Investigador Principal: ANDRÉS CERVANTES RUIPEREZ

2017/216 . INSTITUTO SALUD CARLOS III . 2018

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