Cardiac Magnetic Resonance Imaging Predicts Recovery of Left Ventricular Function in Acute Onset Cardiomyopathy - 12/01/12
Corresponding author at: The Alfred Hospital, Commercial Rd, Prahran, 3181, Australia. Tel.: +61 3 9076 2000.Résumé |
Background |
In acute onset cardiomyopathy, acute myocarditis is an important cause, as it is associated with a greater likelihood of recovery of cardiac function and its presence may direct specific therapies. Myocarditis can be detected by cardiac magnetic resonance imaging (CMR); however its diagnostic utility and relation to prognosis in acute onset cardiomyopathy are unknown.
Methods |
We performed CMR on 61 patients with acute onset cardiomyopathy and a left ventricular ejection fraction (LVEF) <55%. CMR included assessment of myocardial function, relative myocardial oedema, myocardial inflammation (using global relative enhancement [GRE] of the myocardium 4minutes post Gad-DTPA contrast) and necrosis or fibrosis (with late gadolinium enhancement [LGE]). Patients were followed up at six months to evaluate LVEF, morbidity and mortality.
Results |
There was a greater improvement in LVEF at follow up in those with myocardial inflammation identified by elevated GRE compared to those without (mean increase 19.2±2.5% vs. 6.7±1.7%, p<0.001). However, the presence of myocardial oedema or LGE alone was not associated with a greater recovery of LVEF (p=NS for both). Myocardial inflammation in patients with a baseline LVEF<35% was also associated with a greater recovery of LVEF (mean increase 21.5±2.9% vs. 9.1±3.0%, p<0.01).
Conclusion |
Myocardial inflammation identified by an elevated GRE predicts recovery of LV function in patients with acute onset cardiomyopathy.
Le texte complet de cet article est disponible en PDF.Abbreviations : LVEF, TTE, MRI, CMR, GRE, STIR, LGE, IDCM, NYHA, AICD, GCBPS
Keywords : Myocarditis, Cardiomyopathy, Cardiac magnetic resonance imaging, Prognosis, Ejection fraction, Global relative enhancement
Plan
Vol 21 - N° 1
P. 30-35 - janvier 2012 Retour au numéro
Article précédent
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