Effect of Finerenone on Myocardial Fibrosis and Cardiac Function in HFmrEF/HFpEF Patients

Inclusion criteria

• . Aged 18 to 80 years (inclusive), any gender.
• . Symptomatic heart failure (NYHA class II-IV).
• . Emergency department visit or hospitalization for HF within the past 3 months, or escalation of intravenous or oral diuretic therapy for worsening HF within the past 3 months.
• . LVEF ≥40% measured by echocardiography or CMR within the past 30 days prior to screening.
• . NT-proBNP ≥300 pg/mL for patients in sinus rhythm; NT-proBNP ≥900 pg/mL for patients with atrial fibrillation.
• . Presence of myocardial fibrosis, defined as ECV ≥27% measured by CMR at baseline.
• . Capable of providing voluntary written informed consent.