Azusa Ichinose MD, Presenter: Nothing to Disclose

Hiroki Otani MD, Abstract Co-Author: Nothing to Disclose

MInako Oikawa MD, Abstract Co-Author: Nothing to Disclose

Kei Takase MD, Abstract Co-Author: Nothing to Disclose

Haruo Saito MD, Abstract Co-Author: Nothing to Disclose

Shoki Takahashi MD, Abstract Co-Author: Nothing to Disclose

Delayed contrast-enhanced cardiovascular magnetic resonance (DE-CMR) shows myocardial hyperenhancement (HE) in patients with ischemic and nonischemic cardiomyopathy. We hypothesized that the extent and pattern of myocardial HE by DE-CMR predict cardiac events in patients with nonischemic dilated cardiomyopathy (DCM).

DE-CMR was performed in 39 patients referred for congestive heart failure due to nonischemic DCM, whose left ventricular end-diastolic volume index (LVEDVI)>90ml/m² and LV ejection fraction (LVEF)<50%. Using a 17-segment model of the LV, the extent of regional myocardial HE (regional HE) was visually scored on a 4-point scale (0=none, 1=1 to 25%, 2=26 to 50%, 3=51 to 75%, 4=76 to 100% enhancement) in each segment. The global extent of HE (global HE) was calculated as summation of the regional HE scores. Regional wall thickness (rWT), LVEF and LVEDVI were measured using cine MRI. We followed the patients for a mean of 21±12 months.

Myocardial HE was present in 26 patients (66%). During the follow-up period, 7/12(58%) patients with global HE>=9 points had cardiac events whereas 3/27(11%) patients with global HE<9 points had cardiac events (p<0.01). There were 5 patterns of myocardial HE; 1, absence of HE (n=13); 2, spotty HE confined to the right ventricular junction (RV-J) (n=3); 3, striate HE in the midmyocardial layer (n=8); 4, massive HE in the midmyodardial layer (n=8); 5, Epicardial or endocardial type of HE (n=7). The patients in group 4-5 had significantly higher cardiac events compared with the patients in group 1-3 (8/15(53%) vs. 2/24(8%), p<0.01) although rWT, LVEF, LVEDVI were not significantly different between the groups 4-5 and 1-3. 14 of 26 patients with myocardial HE had the spotty HE at the RV-J. Cardiac events were not significantly different whether the area of HE included spotty HE at the RV-J or not (5/14(36%) vs. 4/12(33%), p=NS).

The extent and pattern of myocardial HE by DE-CMR could predict cardiac events in patients with nonischemic DCM independent of thier LV function.

Ichinose, A, Otani, H, Oikawa, M, Takase, K, Saito, H, Takahashi, S, The Extent and Pattern of Myocardial Hyperenhancement by Delayed Contrast-enhanced CMR Predict Cardiac Events in Patients with Heart Failure due to Nonischemic Dilated Cardiomyopathy.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4412425.html