Table 5.
The prognostic implications of fibrosis in HFpEF patients
| Fibrosis-associated marker | Findings | References |
|---|---|---|
| Histology | Fibrosis predicted adverse outcome in HFrEF patients, but NOT in HFpEF patients. | 503 |
| Serum galectin-3 | In a HFpEF population, galectin-3 levels were modestly elevated, were inversely associated with functional performance, and were independently associated with adverse outcome. | 511 |
| Molli-ECV | In HFpEF patients MOLLI-ECV (CMR-assessed) correlated with histological evidence of fibrosis (assessed through trichrome staining in a smaller number of patients). However, ECV-associated fibrosis was not independently associated with adverse outcome. | 512 |
| Serum biomarkers of collagen turnover | In a HFpEF patient population, circulating levels of collagen turnover biomarkers and osteopontin levels were not independently associated with outcome (mortality and hospitalizations), despite association with single-variable analysis. | 513 |
| Serum TSP-2 | Serum TSP-2 levels predicted adverse outcome in HFpEF patients. | 514 |
| Multiple serum biomarkers, including markers of ECM remodelling. | A multimarker approach combining biomarkers reflecting calcification, inflammation, metabolism, angiogenesis and matrix turnover predicted outcome in a HFpEF population. | 515 |
| LGE (late gadolinium enhanced)-MRI | In a HFpEF population, myocardial fibrosis assessed through LGE-MRI was associated with adverse outcome. | 516 |
| CMR | In HFpEF patients, CMR-assessed fibrosis was associated with worse outcome. | 517 |
| CMR | Myocardial fibrosis was associated with worse outcome in both HFpEF patients and in subjects ‘at risk’ for HFpEF (based on high BNP levels). HFpEF patients without fibrosis had better outcome. | 509 |
| CMR | Myocardial fibrosis assessed through CMR-based extracellular volume assessment was increased in HFpEF patients and was an independent predictor of outcome. | 518 |