Heart failure and cardiomyopathy

Heart failure and cardiomyopathy alter chamber size, pump function, myocardial mechanics, filling behavior, and atrial remodeling. CardiacNexus phenotypes are most useful here when they are read as a pattern rather than as a single threshold.

Modality
Cine short-axis, cine long-axis, native T1, strain
Pipeline step
Clinical interpretation
Outputs
Ventricular, atrial, strain, and tissue phenotypes
Maturity
Clinician review draft

What clinicians look for

Clinicians usually inspect LV and RV size, ejection fraction, stroke volume, cardiac output, myocardial mass, atrial size, atrial emptying, strain, and tissue characterization. Preserved EF does not exclude abnormal mechanics or filling; reduced strain, atrial enlargement, abnormal LA emptying, or elevated native T1 may add context [1].

Relevant CardiacNexus phenotypes

Phenotype pageMeasurements to inspectInterpretation role
Ventricular structureEDV, ESV, indexed volumes, sphericityChamber remodeling and dilation pattern
Ventricular functionSV, EF, CO, CIPump performance and output context
Ventricular mechanics and strainCircumferential/radial strain, strain rate, torsionSubclinical or non-EF mechanics
Atrial functionReservoir, conduit, booster EF, PERFilling pressure and atrial compensation context
Myocardial tissue characterizationNative T1, corrected T1Fibrosis, edema, or infiltration context

Interpretation patterns

Dilated cardiomyopathy often motivates review of increased ventricular volumes, reduced EF, reduced strain, and secondary atrial enlargement. HFpEF interpretation often leans more on LA function, ventricular mass, aortic stiffness, and tissue markers than on EF alone [2].

Limitations

CardiacNexus does not classify heart failure subtype. BSA, heart rate, pressure values, ECG timing, and segmentation QC determine whether indexed and functional summaries are reliable.

Source audit

  • Draft primer checked against promoted ventricular, atrial, strain, cross-chamber, and myocardial tissue phenotype pages.
  • Heart-failure and cardiomyopathy wording is constrained to pattern interpretation; no phenotype is presented as a diagnostic rule.
  • docs/data/reference_sources.yml exists and is the current registry for the cited CMR, deformation, and tissue-characterization context.
  • Textbook context boundary: broad Braunwald/Hurst heart-failure and cardiomyopathy background was treated only as clinical context; the page-specific phenotype literature is sufficient for draft rollout.
  • Textbook routes checked: Braunwald Pathophysiology of Heart Failure pages 29-46, Clinical Assessment of Heart Failure pages 47-58, HFrEF management pages 85-119, and HFpEF pages 128-142. These sources are broad clinical context only; this primer does not surface management guidance.

References

  1. Marwick TH. Ejection Fraction Pros and Cons. Journal of the American College of Cardiology. 2018;72(19):2360-2379.
  2. Barison A, Aimo A, Todiere G, Grigoratos C, Aquaro GD, Emdin M. Cardiovascular Magnetic Resonance for the Diagnosis and Management of Heart Failure with Preserved Ejection Fraction. Heart Failure Reviews. 2022;27(1):191-205.
  3. Carlsson M, Andersson R, Markenroth Bloch K, Steding-Ehrenborg K, Mosen H, Stahlberg F, Ekmehag B, Arheden H. Cardiac Output and Cardiac Index Measured with Cardiovascular Magnetic Resonance in Healthy Subjects, Elite Athletes and Patients with Congestive Heart Failure. Journal of Cardiovascular Magnetic Resonance. 2012;14(1):50.