P13 Left atrial dilatation on cardiovascular magnetic resonance imaging predicts adverse outcomes in acute heart failure

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Introduction We sought to determine potential Cardiovascular Magnetic Resonance (CMR) biomarkers associated with re-admission and mortality in patients admitted with acute heart failure. Methods We reviewed the CMR scan results of all patients with acute heart failure admitted to our specialised Heart Failure Unit over a 4.5-year period (August 2018 - December 2022). Morbidity and mortality data including major adverse cardiovascular events (MACE) were recorded. A multivariate logistic regression analysis was performed to determine CMR parameters associated with poorer clinical outcomes. Results 85 patients were included, 75% (64) patients were male, mean age was 69±13 years and the main reason for admission was symptomatic dyspnoea and peripheral oedema (80% patients). Most patients had HFrEF (78%) and the main indication for inpatient CMR imaging was to investigate new LVSD (56% patients). Non-ischaemic cardiomyopathy was found in 65% of this cohort on CMR, 76% had invasive coronary assessment for the evaluation of acute heart failure. Within 30 days following hospital discharge, 10 patients (12%) were readmitted, and 2 patients (2%) died during admission. Left atrial area (indexed for BSA) was the only CMR parameter significantly associated with 30-day readmission or mortality. Conclusions CMR plays a crucial role in diagnosing heart failure and influenced the management of 64% patients in our study. Left atrial dilation was independently associated with 30-day readmission and death in acute heart failure admissions. Further studies evaluating this sub-group of patients with earlier follow-up and closer monitoring should be considered.

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