Evidence mapPaperPMID 40533773Full record

ArticleCardiovascular diabetology2025

Atrial dysfunction: a contrast-free marker for HFpEF in obese diabetics-insights from comprehensive CMR and serum biomarker analyses.

Rebecca Elisabeth Beyer, Maximilian Leo Müller, Patrick Doeblin, Stefanie Maria Werhahn, Amedeo Chiribiri, Carsten Tschöpe, Smita Sampath, G Brandon Atkins, Dawn Cislak, An Bautmans and 15 more

Abstract read
In one paragraph

Article in Cardiovascular diabetology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Observational
  2. Review
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

25 authors.

Rebecca Elisabeth BeyerDepartment of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité- Medical Heart Center of Charité and German Heart Institute Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
Maximilian Leo MüllerDepartment of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité- Medical Heart Center of Charité and German Heart Institute Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
Patrick DoeblinDepartment of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité- Medical Heart Center of Charité and German Heart Institute Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
Stefanie Maria WerhahnDepartment of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité- Medical Heart Center of Charité and German Heart Institute Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
Amedeo ChiribiriSchool of Biomedical Engineering and Imaging Sciences, King's College London, BHF Centre of Excellence and the NIHR Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust, The Rayne Institute, St Thomas' Hospital, London, UK.
Carsten TschöpeDepartment of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité- Medical Heart Center of Charité and German Heart Institute Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
Smita SampathQuantitative Biosciences, MSD, Singapore, Singapore.
G Brandon AtkinsMerck & Co., Inc., Rahway, NJ, USA.
Dawn CislakMerck & Co., Inc., Rahway, NJ, USA.
An BautmansMerck & Co., Inc., Rahway, NJ, USA.
John PalczaMerck & Co., Inc., Rahway, NJ, USA.
Tom McAvoyMerck & Co., Inc., Rahway, NJ, USA.
Asad Abu BakarMerck & Co., Inc., Rahway, NJ, USA.
Anita Y H LeeMerck & Co., Inc., Rahway, NJ, USA.
Xuemei ZhaoMerck & Co., Inc., Rahway, NJ, USA.
Maximilian G PoschCharité Research Organisation GmbH, Berlin, Charitéplatz 1, 10117, Berlin, Germany.
Johannes WieditzDepartment of Medical Statistics, University Medical Center Göttingen, Göttingen, Germany.
Radu TanacliDepartment of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité- Medical Heart Center of Charité and German Heart Institute Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
Victoria ZieschangDepartment of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité- Medical Heart Center of Charité and German Heart Institute Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
Mithal NassarDepartment of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité- Medical Heart Center of Charité and German Heart Institute Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
Seyedeh Mahsa ZamaniDepartment of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité- Medical Heart Center of Charité and German Heart Institute Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
Christian StehningPhilips Clinical Science, Hamburg, Germany.
Frank EdelmannDepartment of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité- Medical Heart Center of Charité and German Heart Institute Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
Djawid HashemiDepartment of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité- Medical Heart Center of Charité and German Heart Institute Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
Sebastian KelleDepartment of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité- Medical Heart Center of Charité and German Heart Institute Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany. sebastian.kelle@dhzc-charite.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe diagnostic criteria for HFpEF remain inconsistently defined, further confounded by comorbidities such as obesity and type 2 diabetes mellitus (T2DM), which are thought to contribute to its pathogenesis via chronic pro-inflammatory mechanisms. This study aimed to evaluate the relationship between advanced cardiac magnetic resonance (CMR) imaging and pro-fibrotic and inflammatory serum biomarkers, assessing their potential to discriminate HFpEF from associated comorbid conditions.

methodsThis was an exploratory analysis of a prospective cohort study of 35 obese/overweight participants (mean age 64 ± 8 years, 23% females), including 16 with T2DM, 13 with HFpEF (NYHA II-III) and T2DM, and 6 healthy controls. All subjects underwent comprehensive contrast-enhanced CMR at a 3 T scanner (Philips Ingenia, The Netherlands), including assessment of left ventricular and left atrial (LA) volumetry and function, myocardial perfusion reserve (MPR), and diffuse fibrosis imaging (ECV). Obtained serum biomarkers were Pentraxin-3, Galectin-3 and Interleukin-1 Receptor-Like 1 (IL1RL1). Statistical analyses included one-way ANOVA, Tukey test, Pearson's correlation, regression and receiver operating characteristic analyses, and intra-class correlation.

resultsIn multivariable regression, impaired measures of LA structure and function emerged as the only independent discriminators of HFpEF, with LA maximum volume showing an OR of 1.13 (95% CI 1.05-1.28), reservoir strain of 0.71 (95% CI 0.44-0.89), conduit strain of 0.57 (95% CI 0.32-0.82) and booster strain of 0.70 (95% CI 0.48-0.89) per unit increase. No differences in MPR nor ECV were observed between the groups. While serum biomarkers Galectin-3 and Pentraxin-3 were significantly higher in HFpEF vs. obese controls (16.1 ng/ml ± 3.8 ng/ml vs. 10.6 ng/ml ± 3.7 ng/ml, p = 0.011, and 0.84 ng/ml ± 0.67 ng/ml vs. 0.21 ng/ml ± 0.05 ng/ml, p = 0.031, respectively), these biomarkers remained within normal limits and showed only moderate correlations with CMR metrics. Highest inter-study reproducibility was seen in MPR (ICC: 0.94), LA Reservoir Strain (ICC: 0.84) and serum biomarkers (ICC: 0.087-0.93).

conclusionCMR markers of diffuse fibrosis and microvascular dysfunction may not differentiate HFpEF from obese or diabetic controls. However, left atrial function assessment may evolve to be a reproducible and practical CMR marker, effectively distinguishing HFpEF independent of fibrotic remodeling.

Indexed as

Atrial Function, LeftC-Reactive ProteinDiabetes Mellitus, Type 2Galectin 3Heart FailureInflammation MediatorsMagnetic Resonance Imaging, CineObesityStroke VolumeAgedBiomarkersBlood ProteinsCase-Control StudiesFemaleFibrosisGalectinsBiomarkersBlood ProteinsC-Reactive ProteinGalectin 3GalectinsInflammation MediatorsInterleukin-1 Receptor-Like 1 ProteinLGALS3 protein, humanPentraxinsSerum Amyloid P-ComponentBiomarkersCardiac magnetic resonanceHFpEFIL1RL1Left atrial strainObesityType 2 diabetes mellitus

Identifiers

PMID40533773
PMCPMC12175437

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.