MRI staging of haemodynamic congestion and clinical outcomes
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By
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Cesare Mantini
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Anna Sorella
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Daniele Falco
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Darien Calvo Garcia
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Daniele Petrucci
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Mauro Gianni Perrucci
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Sabina Gallina
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Massimo Caulo
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Luca Saba
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Alberto Clemente
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Mohammed Yunus Khanji
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Giovanni Donato Aquaro
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Pankaj Garg
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Fabrizio Ricci
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June 10, 2026
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Clinical Scorecard: Assessment of Haemodynamic Congestion via MRI and Its Impact on Clinical Outcomes
At a Glance
| Category | Detail |
|---|
| Condition | Heart Failure (HF) |
| Key Mechanisms | Elevated left ventricular filling pressure (LVFP) and its assessment via MRI. |
| Target Population | Individuals with heart failure and those undergoing cardiovascular MRI. |
| Care Setting | Outpatient cardiovascular imaging. |
Key Highlights
- MRI provides a non-invasive alternative to right heart catheterisation for assessing congestion.
- Pulmonary blood volume (PBV) and pulmonary transit time (PTT) derived from MRI have prognostic value.
- A simple MRI-based model integrating left atrial volume (LAV) and left ventricular mass (LVM) accurately estimates PAWP.
Guideline-Based Recommendations
Diagnosis
- Use MRI to assess LVFP and congestion in heart failure patients.
Management
- Integrate MRI-derived metrics into the management of heart failure.
Monitoring & Follow-up
- Regularly monitor pulmonary transit time and pulmonary blood volume in heart failure patients.
Risks
- Consider contraindications to MRI and gadolinium-based contrast administration.
Patient & Prescribing Data
262 outpatients undergoing cardiovascular MRI.
MRI metrics can inform treatment decisions and prognostic assessments.
Clinical Best Practices
- Utilize MRI for non-invasive assessment of cardiac structure and function.
- Employ peak atrial longitudinal strain analysis for evaluating left atrial function.
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