Use of cardiac magnetic resonance imaging in patients hospitalized for acute heart failure: insights from the French nationwide OFICA-2 cohort
B Alos, A Altes, D Legallois, M Doublet, A Menet, E Puymirat, A Jacquier, J Corre, A Cohen, C Delmas, T Genet, H Cochet, N Mewton, D Logeart, C BouletiAbstract
Introduction
Cardiac magnetic resonance (CMR) is theoretically a cornerstone of acute heart failure (AHF) management, providing comprehensive assessment of cardiac structure and function. However, real-world access to CMR within clinically relevant timeframes remains heterogeneous. We aimed to evaluate contemporary CMR utilization in patients hospitalized for AHF and to identify associated demographic, clinical, and institutional factors.
Methods
We analyzed data from the national, prospective, multicenter OFICA2 cohort, including consecutive adults hospitalized for AHF across 80 French centers between March and April 2021. Patients who died during index hospitalization or had contraindications to CMR were excluded. Clinical data were complemented by linkage with the French National Health Data System to capture CMR examinations during hospitalization and up to one year after discharge.
Results
Among 906 eligible patients (mean age 74.7 years, 42.1% women), 116 (12.8%) underwent CMR during hospitalization or within one year. CMR use was independently associated with younger age, absence of prior myocardial infarction, reduced LVEF, and dilated cardiomyopathy rather than valvular or hypertensive heart disease. Among first-episode AHF, male sex was associated with more frequent referral. Substantial institutional disparities were observed, with higher CMR use in university hospitals. Among patients with guideline-based indications, only 10.9% (Class I) and 15.0% (Class II) underwent CMR.
Conclusion
In this nationwide cohort of hospitalized AHF patients, CMR utilization was low (12.8%) despite guideline recommendations, with marked disparities related to patient profile and institutions. These findings highlight the need for coordinated strategies to improve equitable and timely access to CMR in heart failure care.Characteristics according to CMR useFor image description, please refer to the figure legend and surrounding text.Independent predictors of CMR useFor image description, please refer to the figure legend and surrounding text.