Use of cardiac magnetic resonance imaging after hospitalization for acute heart failure: insights from the French nationwide OFICA-2 cohort

Abstract Background Cardiac magnetic resonance (CMR) has a central role in the management of patients with acute heart failure (AHF), but timely access remains heterogeneous. We investigated real-world CMR use in patients hospitalized for AHF and its associations with demographic, clinical, and institutional characteristics. Methods In the nationwide prospective OFICA2 cohort, conducted from March to April 2021 across 80 centers, we included 906 patients hospitalized for AHF, discharged alive, and without contraindications to CMR (mean age 74.7 years, 42.1% women). CMR use was identified through national billing codes during hospitalization and within one year using linked national administrative data. Analyses assessed CMR use across patient subgroups, hospital types, and care settings. Results Overall, 116 patients (12.8%) underwent CMR during hospitalization or within one year. CMR use was more frequent in younger patients, those without myocardial infarction, those with reduced LVEF, and patients with dilated rather than hypertensive or valvular cardiomyopathy. Among patients hospitalized for a first AHF episode, male sex was also associated with higher referral rates. CMR use varied across hospital types and care settings, with higher rates in university hospitals and intensive care units. Among patients with potential CMR indications according to the 2016 ESC Heart Failure guidelines, only 10.9% (class I) and 15.0% (class II) underwent the examination. Conclusions In this nationwide AHF cohort, real-world use of CMR remained limited, even among patients with potential guideline-based indications, with marked patient- and institution-level disparities. These findings support coordinated efforts to improve timely access to CMR in heart failure care.

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Journal
European Heart Journal - Imaging Methods and Practice
Published
2026-09-10
DOI
https://doi.org/10.1093/ehjimp/qyag159
Primary Topic
Cardiac Imaging and Diagnostics
Type
article
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article

Use of cardiac magnetic resonance imaging after hospitalization for acute heart failure: insights from the French nationwide OFICA-2 cohort

Jérémy Laïk, Étienne Puymirat, L. Legrand, Claire Bouleti et al.
European Heart Journal - Imaging Methods and Practice
Cardiac Imaging and Diagnostics
article

Use of cardiac magnetic resonance imaging after hospitalization for acute heart failure: insights from the French nationwide OFICA-2 cohort

Jérémy Laïk, Étienne Puymirat, L. Legrand, Claire Bouleti, Nicolas Lamblin, Nathan Mewton, Laurent Desprets, Hubert Cochet, Jean‐Noël Trochu, Marjorie Canu, Damien Legallois, Benjamin Alos, Maxime Doublet, Jérôme Corré, Aymeric Menet, Damien Logeart, Clément Delmas, Alexis Jacquier, Thibaud Genet, Alexandre Altes, François Picard, Charlotte Dagrenat, Christophe Thuaire, Ariel Cohen, Jerôme Costa
article en

Abstract

Abstract Background Cardiac magnetic resonance (CMR) has a central role in the management of patients with acute heart failure (AHF), but timely access remains heterogeneous. We investigated real-world CMR use in patients hospitalized for AHF and its associations with demographic, clinical, and institutional characteristics. Methods In the nationwide prospective OFICA2 cohort, conducted from March to April 2021 across 80 centers, we included 906 patients hospitalized for AHF, discharged alive, and without contraindications to CMR (mean age 74.7 years, 42.1% women). CMR use was identified through national billing codes during hospitalization and within one year using linked national administrative data. Analyses assessed CMR use across patient subgroups, hospital types, and care settings. Results Overall, 116 patients (12.8%) underwent CMR during hospitalization or within one year. CMR use was more frequent in younger patients, those without myocardial infarction, those with reduced LVEF, and patients with dilated rather than hypertensive or valvular cardiomyopathy. Among patients hospitalized for a first AHF episode, male sex was also associated with higher referral rates. CMR use varied across hospital types and care settings, with higher rates in university hospitals and intensive care units. Among patients with potential CMR indications according to the 2016 ESC Heart Failure guidelines, only 10.9% (class I) and 15.0% (class II) underwent the examination. Conclusions In this nationwide AHF cohort, real-world use of CMR remained limited, even among patients with potential guideline-based indications, with marked patient- and institution-level disparities. These findings support coordinated efforts to improve timely access to CMR in heart failure care.

European Heart Journal - Imaging Methods and Practice
Université Claude Bernard Lyon 1 (FR), Université de Tours (FR), Université de Bordeaux (FR), Inserm (FR), Lyon College (US), Université Catholique de Lille (FR), Université Paris Cité (FR), Singleton Hospital (GB), Institut Pasteur de Lille (FR), American Society of Echocardiography (US), Centre Hospitalier Universitaire de Bordeaux (FR), Université de Poitiers (FR), Sorbonne Université (FR), Electrophysiology and Heart Modeling Institute (FR), Assistance Publique Hôpitaux de Marseille (FR), Centre Hospitalier Universitaire de La Réunion (RE), Centre Hospitalier Universitaire de Tours (FR), Assistance Publique – Hôpitaux de Paris (FR), Toulouse Mathematics Institute (FR), Hospices Civils de Lyon (FR), Hôpital Saint-Antoine (FR), Centre Hospitalier De Pau (FR), Centre Hospitalier Universitaire de Reims (FR), Normandie Université (FR), Les Hôpitaux de Chartres (FR), Hôpital Lariboisière (FR), Laboratoire de recherche en cardiovasculaire, métabolisme, diabétologie et nutrition (FR), Laboratoire Vision Action Cognition (FR), European Hospital (IT), Institut du Thorax (FR), Unité de recherche sur les maladies cardiovasculaires et métaboliques (FR), Université Grenoble Alpes (FR), Université de Reims Champagne-Ardenne (FR), Université de Caen Normandie (FR)
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