Female physician listens to senior patient's heart to look for heart failure signs.
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Researchers based at the University of East Anglia in the U.K. have confirmed that accounting for biological sex when assessing patients for heart failure improves accuracy of diagnosis.

The team behind the work, published in the European Heart Journal Open, fine-tuned a method for diagnosing the condition using magnetic resonance imaging (MRI) and were able to identify 16.5% more women than before.

Heart failure, where the heart gradually loses its ability to pump blood around the body efficiently, impacts around 6.5 million people in the U.S. and it is estimated that there are almost a million new cases diagnosed each year.

There are different types of heart failure, which are known to impact men and women differently. For example, heart failure with preserved ejection fraction affects more women than men.

Despite this, there are no validated sex-specific tools for heart failure diagnosis that clinicians can use, according to lead author Pankaj Garg, a consultant cardiologist at the Norfolk and Norwich University Hospital, and co-authors.

Methods for diagnosing the condition include an invasive, but accurate method using a catheter to measure heart pressure, and ultrasound-based echocardiograms, which are non-invasive, but less accurate. MRI can also be used, and the team previously developed an equation to allow them to calculate pressure in the heart using data collected during MRI scanning.

“Doctors tend to use echocardiograms, which are based on ultrasound, to assess heart function, but this is inaccurate in up to 50% of cases. Using MRI, we can get much more accurate images of how the heart is working,” explained co-author Gareth Matthews, of the University of East Anglia’s Medical School, in a press statement.

However, the equation they developed was less accurate in women, particularly if the condition was only in its early stages. To try and combat this problem, Garg and the team developed a sex-specific cardiac magnetic resonance model to estimate left ventricular filling pressure in heart failure.

They created the model using a group of 835 people (60% female) and then tested it for validation purposes in 454 individuals (36% female).

The model accounted for the fact that women with heart failure had higher systolic blood pressure and mean heart rate than men in the group, but lower levels of chronic obstructive pulmonary disease. The women in the group also had higher rates of heart failure with preserved ejection fraction, as expected, whereas men were more likely to have heart failure with mid-range ejection fraction.

“By refining the method for women specifically, we were able to diagnose 16.5% more females with heart failure,” said Garg.

“This could have huge impact in the National Health Service, which diagnoses around 200,000 patients with heart failure each year.”

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