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...

Full description

Saved in:
Bibliographic Details
Main Authors: Djawid Hashemi, Karl Jakob Weiß, Patrick Doeblin, Moritz Blum, Radu Tanacli, Hana Camdzic, Hans-Dirk Düngen, Frank Edelmann, Titus Kuehne, Marcus Kelm, Sebastian Kelle
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Cardiovascular Medicine
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fcvm.2025.1458152/full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832585018077085696
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).
format Article
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
work_keys_str_mv AT djawidhashemi exploringtheassociationbetweentissuesodiumcontentheartfailuresubtypesandsymptomburdeninsightsfrommagneticresonanceimaging
AT djawidhashemi exploringtheassociationbetweentissuesodiumcontentheartfailuresubtypesandsymptomburdeninsightsfrommagneticresonanceimaging
AT djawidhashemi exploringtheassociationbetweentissuesodiumcontentheartfailuresubtypesandsymptomburdeninsightsfrommagneticresonanceimaging
AT djawidhashemi exploringtheassociationbetweentissuesodiumcontentheartfailuresubtypesandsymptomburdeninsightsfrommagneticresonanceimaging
AT karljakobweiß exploringtheassociationbetweentissuesodiumcontentheartfailuresubtypesandsymptomburdeninsightsfrommagneticresonanceimaging
AT karljakobweiß exploringtheassociationbetweentissuesodiumcontentheartfailuresubtypesandsymptomburdeninsightsfrommagneticresonanceimaging
AT karljakobweiß exploringtheassociationbetweentissuesodiumcontentheartfailuresubtypesandsymptomburdeninsightsfrommagneticresonanceimaging
AT patrickdoeblin exploringtheassociationbetweentissuesodiumcontentheartfailuresubtypesandsymptomburdeninsightsfrommagneticresonanceimaging
AT patrickdoeblin exploringtheassociationbetweentissuesodiumcontentheartfailuresubtypesandsymptomburdeninsightsfrommagneticresonanceimaging
AT patrickdoeblin exploringtheassociationbetweentissuesodiumcontentheartfailuresubtypesandsymptomburdeninsightsfrommagneticresonanceimaging
AT moritzblum exploringtheassociationbetweentissuesodiumcontentheartfailuresubtypesandsymptomburdeninsightsfrommagneticresonanceimaging
AT radutanacli exploringtheassociationbetweentissuesodiumcontentheartfailuresubtypesandsymptomburdeninsightsfrommagneticresonanceimaging
AT radutanacli exploringtheassociationbetweentissuesodiumcontentheartfailuresubtypesandsymptomburdeninsightsfrommagneticresonanceimaging
AT radutanacli exploringtheassociationbetweentissuesodiumcontentheartfailuresubtypesandsymptomburdeninsightsfrommagneticresonanceimaging
AT hanacamdzic exploringtheassociationbetweentissuesodiumcontentheartfailuresubtypesandsymptomburdeninsightsfrommagneticresonanceimaging
AT hanacamdzic exploringtheassociationbetweentissuesodiumcontentheartfailuresubtypesandsymptomburdeninsightsfrommagneticresonanceimaging
AT hansdirkdungen exploringtheassociationbetweentissuesodiumcontentheartfailuresubtypesandsymptomburdeninsightsfrommagneticresonanceimaging
AT hansdirkdungen exploringtheassociationbetweentissuesodiumcontentheartfailuresubtypesandsymptomburdeninsightsfrommagneticresonanceimaging
AT frankedelmann exploringtheassociationbetweentissuesodiumcontentheartfailuresubtypesandsymptomburdeninsightsfrommagneticresonanceimaging
AT frankedelmann exploringtheassociationbetweentissuesodiumcontentheartfailuresubtypesandsymptomburdeninsightsfrommagneticresonanceimaging
AT frankedelmann exploringtheassociationbetweentissuesodiumcontentheartfailuresubtypesandsymptomburdeninsightsfrommagneticresonanceimaging
AT tituskuehne exploringtheassociationbetweentissuesodiumcontentheartfailuresubtypesandsymptomburdeninsightsfrommagneticresonanceimaging
AT tituskuehne exploringtheassociationbetweentissuesodiumcontentheartfailuresubtypesandsymptomburdeninsightsfrommagneticresonanceimaging
AT tituskuehne exploringtheassociationbetweentissuesodiumcontentheartfailuresubtypesandsymptomburdeninsightsfrommagneticresonanceimaging
AT marcuskelm exploringtheassociationbetweentissuesodiumcontentheartfailuresubtypesandsymptomburdeninsightsfrommagneticresonanceimaging
AT marcuskelm exploringtheassociationbetweentissuesodiumcontentheartfailuresubtypesandsymptomburdeninsightsfrommagneticresonanceimaging
AT marcuskelm exploringtheassociationbetweentissuesodiumcontentheartfailuresubtypesandsymptomburdeninsightsfrommagneticresonanceimaging
AT sebastiankelle exploringtheassociationbetweentissuesodiumcontentheartfailuresubtypesandsymptomburdeninsightsfrommagneticresonanceimaging
AT sebastiankelle exploringtheassociationbetweentissuesodiumcontentheartfailuresubtypesandsymptomburdeninsightsfrommagneticresonanceimaging
AT sebastiankelle exploringtheassociationbetweentissuesodiumcontentheartfailuresubtypesandsymptomburdeninsightsfrommagneticresonanceimaging