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Concordant and Discordant Cardiac Magnetic Resonance Imaging Delayed Hyperenhancement Patterns in Patients with Ischemic and Non-Ischemic Cardiomyopathy
Korean Circulation Journal ; : 41-47, 2016.
Article in English | WPRIM | ID: wpr-22792
ABSTRACT
BACKGROUND AND

OBJECTIVES:

The diagnosis of ischemic (ICM) and non-ischemic cardiomyopathy (NICM) is conventionally determined by the presence or absence of coronary artery disease (CAD) in the setting of a reduced left systolic function. However the presence of CAD may not always indicate that the actual left ventricular (LV) dysfunction mechanism is ischemia, as other non-ischemic etiologies can be responsible. We investigated patterns of myocardial fibrosis using delayed hyperenhancement (DHE) on cardiac magnetic resonance (CMR) in ICM and NICM. SUBJECTS AND

METHODS:

Patients with systolic heart failure who underwent a CMR were prospectively analyzed. The heart failure diagnosis was based on the modified Framingham criteria and LVEF <35%. LV dysfunction was classified as ICM or NICM based on coronary anatomy.

RESULTS:

A total of 101 subjects were analyzed; 34 were classified as ICM and 67 as NICM. The DHE pattern was concordant with the conventional diagnosis in 27 (79.4%) of the patients with ICM and 62 (92.5%) of the patients with NCIM. A discordant NICM DHE pattern was present in 8.8% of patients with ICM, and an ICM pattern was detected 6.0% of the patients with NICM. Furthermore, 11.8% of the patients with ICM and 1.5% of those with NICM demonstrated a mixed pattern.

CONCLUSION:

A subset of patients conventionally diagnosed with ICM or NICM based on coronary anatomy demonstrated a discordant or mixed DHE pattern. CMR-DHE imaging can be helpful to determine the etiology of heart failure in patients with persistent LV systolic dysfunction.
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Coronary Artery Disease / Fibrosis / Magnetic Resonance Imaging / Prospective Studies / Diagnosis / Heart Failure, Systolic / Cardiac Imaging Techniques / Heart Failure / Ischemia / Cardiomyopathies Type of study: Diagnostic study / Observational study Limits: Humans Language: English Journal: Korean Circulation Journal Year: 2016 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Coronary Artery Disease / Fibrosis / Magnetic Resonance Imaging / Prospective Studies / Diagnosis / Heart Failure, Systolic / Cardiac Imaging Techniques / Heart Failure / Ischemia / Cardiomyopathies Type of study: Diagnostic study / Observational study Limits: Humans Language: English Journal: Korean Circulation Journal Year: 2016 Type: Article