Newly diagnosed heart failure Circulatory System
Conditions
Interventions
Participants are centrally randomised 1:1 to either coronary angiography first (CATH) followed by cardiac resonance imaging (CMR), or CMR first followed by CATH. Randomisation is done electronically i
Sponsors
German Cardiac Society
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Age =18 years 2. Physical and mental ability to give informed consent 3. Written informed consent for study participation 4. Indication for coronary angiography and signed copies of patient information forms for coronary angiography and CMR 5. Heart failure with reduced ejection fraction and a left ventricular ejection fraction =40% in echocardiography (or comparable imaging modality) within the preceding 3 months 6. Cause of heart failure not yet determined 7. Hospital admission for coronary angiography for further evaluation of heart failure origin or in case of primary in-hospital diagnosis of HFrEF, clinical indication for coronary angiography after best possible cardiac recompensation
Exclusion criteria
Exclusion criteria: 1. Pregnancy 2. End-stage renal disease (glomerular filtration rate <30 ml/min/m² (MDRD) and/or dialysis-dependency) 3. Acute coronary syndrome 4. History of coronary artery disease or myocardial infarction 5. Acutely decompensated heart failure or heart failure stage NYHA IV 6. Valvular stenosis (any) =grade II 7. Standard exclusion criteria for cardiac MRI (e.g., incompatible metallic implants or devices, known, claustrophobia, allergy against gadolinium-based contrast agents, bodily dimensions incompatible with scanner)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Ischaemic cause of heart failure diagnosed via CMR or CATH procedure used as the first modality at baseline | — |
Secondary
| Measure | Time frame |
|---|---|
| Number of CATH procedures that could be avoided when applying the CMR-first strategy: this metric is operationalized as the number of patients in whom the CMR done as a first diagnostic test allowed the researchers to omit an invasive CATH procedure (measured at baseline) | — |
Countries
Germany
Contacts
Public ContactStefan Störk
Outcome results
None listed