Exploring the association between tissue sodium content, heart failure subtypes, and symptom burden: insights from magnetic resonance imaging
AimsHeart failure (HF) is a complex clinical syndrome with high morbidity and mortality, influenced significantly by sodium balance. Recently, magnetic resonance imaging (MRI) has emerged as a non-invasive method to evaluate tissue sodium load in HF patients. This proof-of-principle study investigat...
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Frontiers Media S.A.
2025-01-01
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Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1458152/full |
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author | Djawid Hashemi Djawid Hashemi Djawid Hashemi Djawid Hashemi Karl Jakob Weiß Karl Jakob Weiß Karl Jakob Weiß Patrick Doeblin Patrick Doeblin Patrick Doeblin Moritz Blum Radu Tanacli Radu Tanacli Radu Tanacli Hana Camdzic Hana Camdzic Hans-Dirk Düngen Hans-Dirk Düngen Frank Edelmann Frank Edelmann Frank Edelmann Titus Kuehne Titus Kuehne Titus Kuehne Marcus Kelm Marcus Kelm Marcus Kelm Sebastian Kelle Sebastian Kelle Sebastian Kelle |
author_facet | Djawid Hashemi Djawid Hashemi Djawid Hashemi Djawid Hashemi Karl Jakob Weiß Karl Jakob Weiß Karl Jakob Weiß Patrick Doeblin Patrick Doeblin Patrick Doeblin Moritz Blum Radu Tanacli Radu Tanacli Radu Tanacli Hana Camdzic Hana Camdzic Hans-Dirk Düngen Hans-Dirk Düngen Frank Edelmann Frank Edelmann Frank Edelmann Titus Kuehne Titus Kuehne Titus Kuehne Marcus Kelm Marcus Kelm Marcus Kelm Sebastian Kelle Sebastian Kelle Sebastian Kelle |
author_sort | Djawid Hashemi |
collection | DOAJ |
description | AimsHeart failure (HF) is a complex clinical syndrome with high morbidity and mortality, influenced significantly by sodium balance. Recently, magnetic resonance imaging (MRI) has emerged as a non-invasive method to evaluate tissue sodium load in HF patients. This proof-of-principle study investigates the association between tissue sodium content, assessed by MRI, and HF-related baseline parameters in an outpatient cohort of patients with chronic heart failure, including those with reduced ejection fraction (HFrEF), mildly reduced ejection fraction (HFmrEF), and preserved ejection fraction (HFpEF).Methods and resultsThis prospective study included 29 HF patients (10 HFpEF, 12 HFmrEF, and 7 HFrEF) recruited from two centers in Berlin, Germany. Patients underwent MRI to assess tissue sodium content in the lower extremity. Tissue sodium content was analyzed in relation to baseline HF parameters, including renal function, natriuretic peptide levels, clinical signs of congestion, diuretic use, and New York Heart Association (NYHA) functional class. No significant differences in tissue sodium content were observed between the three HF entities. Sodium values did not differ significantly with clinical signs of congestion or diuretic use. No significant correlations were found between tissue sodium content and renal function (eGFR) or natriuretic peptide levels (NT-proBNP) in any HF group overall. However, explorative analyses showed a positive correlation between free (r = 0.79, p = 0.036) and total (r = 0.79, p = 0.036) tissue sodium content in the skin and NT-proBNP levels in HFrEF patients, but not in HFmrEF and HFpEF. Similarly, there was a correlation between kidney function and both free (r = −0.64, p = 0.025) and total (r = −0.61, p = 0.035) skin sodium in patients with edema and no prior use of loop diuretics, but no correlation for kidney function and both free and total skin sodium in symptomatic patients with established diuretic therapy or asymptomatic patients with no diuretic therapy.ConclusionOur findings provide exploratory insights into the potential diagnostic value of tissue sodium content in HF, particularly in HFrEF patients. With findings showing an association of tissue sodium content with NT-proBNP levels in HFrEF patients and with kidney function in edema patients without prior loop diuretic use, further research is needed to understand the role of tissue sodium content in HF pathophysiology and its potential diagnostic and prognostic implications.
Trial registrationGerman Clinical Trials Register (DRKS), registration number (DRKS00015615). |
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id | doaj-art-af73d2675c7549039eca659badc9a976 |
institution | Kabale University |
issn | 2297-055X |
language | English |
publishDate | 2025-01-01 |
publisher | Frontiers Media S.A. |
record_format | Article |
series | Frontiers in Cardiovascular Medicine |
spelling | doaj-art-af73d2675c7549039eca659badc9a9762025-01-27T06:40:27ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-01-011210.3389/fcvm.2025.14581521458152Exploring the association between tissue sodium content, heart failure subtypes, and symptom burden: insights from magnetic resonance imagingDjawid Hashemi0Djawid Hashemi1Djawid Hashemi2Djawid Hashemi3Karl Jakob Weiß4Karl Jakob Weiß5Karl Jakob Weiß6Patrick Doeblin7Patrick Doeblin8Patrick Doeblin9Moritz Blum10Radu Tanacli11Radu Tanacli12Radu Tanacli13Hana Camdzic14Hana Camdzic15Hans-Dirk Düngen16Hans-Dirk Düngen17Frank Edelmann18Frank Edelmann19Frank Edelmann20Titus Kuehne21Titus Kuehne22Titus Kuehne23Marcus Kelm24Marcus Kelm25Marcus Kelm26Sebastian Kelle27Sebastian Kelle28Sebastian Kelle29Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Berlin, GermanyCharité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyDZHK (German Centre for Cardiovascular Research), Berlin, GermanyBerlin Institute of Health at Charité – Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité Digital Clinician Scientist Program, Berlin, GermanyDeutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Berlin, GermanyCharité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyDZHK (German Centre for Cardiovascular Research), Berlin, GermanyDeutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Berlin, GermanyCharité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyDZHK (German Centre for Cardiovascular Research), Berlin, GermanyBrookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United StatesDeutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Berlin, GermanyCharité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyDZHK (German Centre for Cardiovascular Research), Berlin, GermanyDeutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Berlin, GermanyCharité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyDeutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Berlin, GermanyCharité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyDeutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Berlin, GermanyCharité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyDZHK (German Centre for Cardiovascular Research), Berlin, GermanyCharité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyDZHK (German Centre for Cardiovascular Research), Berlin, GermanyDeutsches Herzzentrum der Charité - Institute of Computer-Assisted Cardiovascular Medicine, Berlin, GermanyCharité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyDZHK (German Centre for Cardiovascular Research), Berlin, GermanyDeutsches Herzzentrum der Charité - Institute of Computer-Assisted Cardiovascular Medicine, Berlin, GermanyDeutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, Berlin, GermanyCharité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyDZHK (German Centre for Cardiovascular Research), Berlin, GermanyAimsHeart failure (HF) is a complex clinical syndrome with high morbidity and mortality, influenced significantly by sodium balance. Recently, magnetic resonance imaging (MRI) has emerged as a non-invasive method to evaluate tissue sodium load in HF patients. This proof-of-principle study investigates the association between tissue sodium content, assessed by MRI, and HF-related baseline parameters in an outpatient cohort of patients with chronic heart failure, including those with reduced ejection fraction (HFrEF), mildly reduced ejection fraction (HFmrEF), and preserved ejection fraction (HFpEF).Methods and resultsThis prospective study included 29 HF patients (10 HFpEF, 12 HFmrEF, and 7 HFrEF) recruited from two centers in Berlin, Germany. Patients underwent MRI to assess tissue sodium content in the lower extremity. Tissue sodium content was analyzed in relation to baseline HF parameters, including renal function, natriuretic peptide levels, clinical signs of congestion, diuretic use, and New York Heart Association (NYHA) functional class. No significant differences in tissue sodium content were observed between the three HF entities. Sodium values did not differ significantly with clinical signs of congestion or diuretic use. No significant correlations were found between tissue sodium content and renal function (eGFR) or natriuretic peptide levels (NT-proBNP) in any HF group overall. However, explorative analyses showed a positive correlation between free (r = 0.79, p = 0.036) and total (r = 0.79, p = 0.036) tissue sodium content in the skin and NT-proBNP levels in HFrEF patients, but not in HFmrEF and HFpEF. Similarly, there was a correlation between kidney function and both free (r = −0.64, p = 0.025) and total (r = −0.61, p = 0.035) skin sodium in patients with edema and no prior use of loop diuretics, but no correlation for kidney function and both free and total skin sodium in symptomatic patients with established diuretic therapy or asymptomatic patients with no diuretic therapy.ConclusionOur findings provide exploratory insights into the potential diagnostic value of tissue sodium content in HF, particularly in HFrEF patients. With findings showing an association of tissue sodium content with NT-proBNP levels in HFrEF patients and with kidney function in edema patients without prior loop diuretic use, further research is needed to understand the role of tissue sodium content in HF pathophysiology and its potential diagnostic and prognostic implications. Trial registrationGerman Clinical Trials Register (DRKS), registration number (DRKS00015615).https://www.frontiersin.org/articles/10.3389/fcvm.2025.1458152/fullheart failuretissue sodium contentmagnetic resonance imaging (MRI)ejection fraction (EF)pathophysiology |
spellingShingle | Djawid Hashemi Djawid Hashemi Djawid Hashemi Djawid Hashemi Karl Jakob Weiß Karl Jakob Weiß Karl Jakob Weiß Patrick Doeblin Patrick Doeblin Patrick Doeblin Moritz Blum Radu Tanacli Radu Tanacli Radu Tanacli Hana Camdzic Hana Camdzic Hans-Dirk Düngen Hans-Dirk Düngen Frank Edelmann Frank Edelmann Frank Edelmann Titus Kuehne Titus Kuehne Titus Kuehne Marcus Kelm Marcus Kelm Marcus Kelm Sebastian Kelle Sebastian Kelle Sebastian Kelle Exploring the association between tissue sodium content, heart failure subtypes, and symptom burden: insights from magnetic resonance imaging Frontiers in Cardiovascular Medicine heart failure tissue sodium content magnetic resonance imaging (MRI) ejection fraction (EF) pathophysiology |
title | Exploring the association between tissue sodium content, heart failure subtypes, and symptom burden: insights from magnetic resonance imaging |
title_full | Exploring the association between tissue sodium content, heart failure subtypes, and symptom burden: insights from magnetic resonance imaging |
title_fullStr | Exploring the association between tissue sodium content, heart failure subtypes, and symptom burden: insights from magnetic resonance imaging |
title_full_unstemmed | Exploring the association between tissue sodium content, heart failure subtypes, and symptom burden: insights from magnetic resonance imaging |
title_short | Exploring the association between tissue sodium content, heart failure subtypes, and symptom burden: insights from magnetic resonance imaging |
title_sort | exploring the association between tissue sodium content heart failure subtypes and symptom burden insights from magnetic resonance imaging |
topic | heart failure tissue sodium content magnetic resonance imaging (MRI) ejection fraction (EF) pathophysiology |
url | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1458152/full |
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