Concordant and Discordant Cardiac Magnetic Resonance Imaging Delayed Hyperenhancement Patterns in Patients with Ischemic and Non-Ischemic Cardiomyopathy.
- Author:
Eun Kyoung KIM
1
;
Sung A CHANG
;
Jin Oh CHOI
;
James GLOCKNER
;
Brian SHAPIRO
;
Yeon Hyeon CHOE
;
Nowell FINE
;
Shin Yi JANG
;
Sung Mok KIM
;
Wayne MILLER
;
Sang Chol LEE
;
Jae K OH
Author Information
- Publication Type:Original Article
- Keywords: Cardiomyopathies; Magnetic resonance imaging; Cardiac imaging technique
- MeSH: Cardiac Imaging Techniques; Cardiomyopathies*; Coronary Artery Disease; Diagnosis; Fibrosis; Heart Failure; Heart Failure, Systolic; Humans; Ischemia; Magnetic Resonance Imaging*; Prospective Studies
- From:Korean Circulation Journal 2016;46(1):41-47
- CountryRepublic of Korea
- Language:English
- 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.
