Hemodynamic forces as a new prognostic marker in heart failure

Clinical management of heart failure is hampered by a severe lack of practically applicable, mechanistic, and quantitative markers of cardiac health, limiting research efforts and causing physicians to frequently make treatment decisions without adequate evidence. This leads to unnecessary suffering and mortality in the general population. During the last few years, a number of promising quantitative measures of cardiac dysfunction have been developed, based on intracardiac blood flow measurements using magnetic resonance imaging. The purpose of this research proposal is to evaluate the performance of hemodynamic force analysis based on state-of-the-art magnetic resonance flow imaging in a clinical setting, to examine its ability to predict treatment outcome, and ultimately, support clinical decisions.

Specifically, we aim to investigate the ability of hemodynamic force analysis to prospectively predict treatment response in a clinical cohort of patients with heart failure with reduced ejection fraction, before implantation of cardiac resynchronization therapy devices. We will test the hypothesis that transverse forces can predict treatment success, independent of traditional prognostic factors.

This project is the first prospective evaluation of hemodynamic force analysis, a novel imaging biomarker, with the potential to detect heart failure patients unlikely to benefit from cardiac resynchronization therapy. The project may establish hemodynamic force analysis as a clinical screening tool providing prognostic information and a possible therapeutic target for heart failure with left bundle branch block. The method may therefore enable better individualized treatment for patients, potentially reducing morbidity and mortality.