Soenke Langner MD, Presenter: Nothing to Disclose

Joerg Ruppert, Abstract Co-Author: Nothing to Disclose

Lothar Albrecht MD, Abstract Co-Author: Nothing to Disclose

Alexander Staudt, Abstract Co-Author: Nothing to Disclose

Norbert Hosten MD, Abstract Co-Author: Nothing to Disclose

Dilated cardiomyopathy (DCM) is a frequent cause of heart failure. Contrast enhanced magnetic resonance imaging (ceMRI) is a valuable tool to assess cardiac morphology and function in patients with DCM. Some patients show delayed enhancement (DE). In contrast to ischemic myocardial infarction, the pathologic surrogate of DE is unknown in DCM. In a considerable proportion of myocardial biopsies from patients with DCM, virus persistence and myocardial inflammation can be shown. The study compares the histological findings with the presence of DE in ceMRI of DCM patients.

22 patients with DCM underwent ceMRI after myocardial biopsy. Biopsies were taken transvenously from the right ventricular part of the interventricular septum (IVS) and analyzed for the presence of viral genomes and signs of inflammation. MRI was performed on a 1.5T MRI scanner (Symphony, SIEMENS). Images for DE were acquired using an inversion recovery sequence 20 minutes after injection of Gd-DTPA and were visually assessed for the presence of DE. This was categorized regarding the location in the myocardium and the distribution pattern.

Mean patient age was 48.8 yrs. The mean LVEF was 39.0 ± 14.4%; LVEDVI was 119.6 ± 41.1ml/m2, LVESVI was 76.9 ± 39.3ml/m2. Mean LVMMI was 86.8 ± 20.0g/m2. DE was found in 7 patients (31.8%). The most abundant pattern of DE was a stripe-like lesion in the midwall portion of the IVS. There was no significant correlation for DE and the cardiac parameters. 7 myocardial biopsies were positive for viral genomes (31.8%). 3 of the 7 virus-positive patients (42.9%) showed DE versus 4 of the 15 virus-negative patients (26.7%) with no statistically significant difference. Myocardial inflammation was detected in 12 patients (54.5%). DE was present in 3 of these patients (25%) and in 4 of the remaining 10 patients (40%), with no significant difference.

The presence of delayed enhancement does neither correlate to myocardial virus persistence nor to the presence of myocardial inflammation in myocardial biopsies of patients with DCM.

DE in ceMRI of DCM patients does neither correlate to myocardial virus persistence nor to the presence of myocardial inflammation

Langner, S, Ruppert, J, Albrecht, L, Staudt, A, Hosten, N, Delayed Enhancement in Patients with Dilated Cardiomyopathy is Unrelated to Virus Persistence or the Presence of Inflammation in Myocardial Biopsies.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4426826.html